Clinical Significance Of PBD Via PTCD In Patients Undergoing PD With Heavy Malignant Obstructive Jaundice

Pancreaticoduodenectomy(PD) is effective the treatment of pancreatic cancer, lower bile duct carcinoma, periampullary cancer and other malignancies. However, whether it should be done before surgery has been plaguing the general surgeon. Due to the small trauma and relatively simple, percutaneous transhepatic choleductus drainage(PTCD) is gradually popularized in clinical practice. In this study, 78 cases which were underwent PD in our department from October 2015 to October 2012 were analyzed retrospectively. From the discussions we improve our understanding of the value of preoperative biliary drainage(PBD), especially PTCD before surgery.Objection: Explore clinical application of preoperative PTCD in patients with severe malignant obstructive jaundice which underwent pancreaticoduodenectomy, and to analyze the clinical value of PTCD preoperative.Method: Retrospective summary the clinical data of 78 patients with malignant biliary obstruction from the Second Hospital of Jilin University between October 2012 to October 2015. All involved patients were divided into two groups, of which one group underwent biliary drainage and the other group didn’t undergo biliary drainage. All patients underwent standarded pancreaticoduodenectomy. Collect the clinical data, T test and other statistical methods were used to analyze. When P <0.05 the results was statistically significant and was considered statistically significant.Results: In the PTCD group the total bilirubin was(342 ± 35.2) mol/L when the patient is admitted to hospital. The total bilirubin decreased to(167 ± 28.4) mmol / L in 14 days biliary drainage or so before pancreaticoduodenectomy. The difference of the PTCD group is statistically significant(P<0.05). In patients which underwent PTCD before surgery there are complications such as dehydration, blockage, and after being treated, the drainage can be continued. The difference of the level of bilirubin is statistically significant between PTCD group and non-PTCD group before PD(P<0.05),but in the average operative time, average blood loss and postoperative hospitalization time the difference is statistically significant(P<0.05),and in blood transfusion there is no significant difference(P>0.05). When comparing the incidence of postoperative complications and mortality there is no significant difference between the PTCD group and non-PTCD group(P> 0.05; P> 0.05). The single incidence of complications the PTCD<14 days group have no significant difference(P>0.05) with that of the PTCD<14 days group; but the statistical difference is significant(P<0.05) in the total incidence of postoperative complications between the two group.Conclusions: Obstructive jaundice is one of the risk factors for pancreaticoduodenectomy. Percutaneous transhepatic choleductus drainage(PTCD) can improve the hyperbilirubinemia of severe obstructive jaundice patients, and provide help for perioperative preparation. Preoperative PTCD can reduce the overall incidence of postoperative complications, which is conducive to postoperative recovery. It is recommended that PTCD should be performed in the patients with severe obstructive jaundice patients for at least 14 days.