| Objective: To evaluate the effect of PTCD(percutaneous transhepatic biliary drainage)and ERCP(retrograde pancreatic cholangiopancreatography)on palliative yellow reduction in patients with low-grade malignant obstructive jaundice,and to evaluate their pros and cons.Through the relevant clinical indicators,objectively evaluate the advantages and disadvantages of the above two methods of yellow reduction in the treatment.Methods: From the 1st Affiliated Hospital of Xinjiang Medical University,from January 1,2014 to January 1,2017,132 patients with low-grade malignant obstructive jaundice were treated and divided into group A according to different treatment methods.In the PTCD group(60 in total,2 in failure)and B/ERCP(72 in total,5 failures),the success rate of surgery,length of hospital stay,and hospitalization were compared between group A and group B Cost,postoperative jaundice,postoperative complications,and postoperative functional decline.Results:After treatment with PTCD and ERCP,the indexes after treatment were significantly better than those before treatment.The difference was statistically significant(P<0.05).It was proved that PTCD and ERCP were significant for the treatment of low malignant obstructive jaundice.The success rates of surgery in group A and group B were 96.7%and 93.1%,respectively(P>0.05).There was no statistical difference between the two groups.However,the duration of operation was 22.74±4.98 min in group A was significantly lower than 33.93±8.19 min in group B.There was a statistical difference between the two groups(P<0.05).The postoperative hospital stay was 3.41±0.81 days in group A and 2.16±0.98 days in group B.There was statistical difference between the two groups(P<0.05).The hospitalization cost of group A was 11597.00±393.33 yuan,and that of group B was 13964.82±501.33 yuan.There was no significant difference between the two groups(P>0.05).After operation,TBil in group A was 163.65±66.36(μmol/L),DBil was 88.54±47.95(μmol/L),TBil in group B was 112.53±57.82(μmol/L),and DBil was 62.91±38.42(μmol/L).There was no difference in the effect of postoperative yellowreduction between the two groups.The yellowing effect of ERCP in the treatment of low malignant obstructive jaundice was equivalent to PTCD There was no statistical difference between the two groups.58 patients in group A were successful.The total postoperative complications were 7 patients,including 4 biliary tract infections,2 biliary tract hemorrhages,and 1 liver abscess,which was about 12.1%.ERCP was successful in67 cases and complications were found in 4 cases.There were 2 cases of secondary acute pancreatitis,1 case of biliary tract infection,and 1 case of spondylolisthesis,which was about 5.9%.Postoperative complications in group A were significantly more than those in group B.Statistical significance.The incidence of postoperative complications of ERCP was significantly lower than that of PTCD.There was statistical difference between the two groups.In group A,the postoperative AST was 66.16±37.73(U/l)and the ALT was 66.82±53.11(U/L).In group B,the postoperative AST was 95.69±31.14(U/l)and the ALT was 108.38±52.82(U/L).).Comparing the liver function of the two groups,the recovery effect of group A was not as good as that of group B,and there was a difference between the two groups(P<0.05).Conclusion: In the treatment of patients with low malignant obstructive jaundice,the success rate of PTCD and ERCP is comparable.Both of them can effectively relieve the stenosis,and ERCP can achieve the same yellowing effect of PTCD.Compared with PTCD,ERCP has fewer postoperative complications,stable electrolytes,short hospital stays,and low hospital costs.Therefore,the use of ERCP is preferred for palliative yellow reduction in patients with low malignant obstructive jaundice. |
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