Effect Analysis Of Different Minimally Invasive Methods For The Treatment Of Malignant Obstructive Jaundice

Objective To explore the clinical treatment effect of four different minimally invasive methods in the treatment of malignant obstructive jaundice.Methods The data of patients with malignant obstructive jaundice who attended the First Affiliated Hospital of Bengbu Medical College from June 2016 to December 2019 were collected and divided into four groups according to the surgical formula:endoscopic stent drainage group（group A）,simple percutaneous hepatobiliary puncture and drainage group（group B）,percutaneous hepatobiliary stent implantation group（group C）,percutaneous hepatobiliary stent combined with ¹²⁵I particle implantation group（group D）.The changes in liver function,the improvement of jaundice,the incidence of complications,the patency time and survival of high and low biliary obstruction were compared among the four groups.Results Compared with preoperative,the serum levels of TBIL,DBIL,ALT,AST,ALP,andγ-GGT in the four groups were significantly decreased at 7 days after operation,and the difference was statistically significant,all P<0.05.The patency time and survival time（first quartile and third quartile）of low biliary obstruction in group A were 9.00（7.00,12.20）months and 10.50（9.00,14.00）months respectively,which were higher than the8.00（4.00,11.00）,9.00（6.00,12.00）of high-level biliary obstruction,P<0.05.The patency time and survival time（first quartile and third quartile）of low biliary obstruction in group D were 12.00（7.50,14.00）months and 13.00（8.50,15.00）months respectively,which were higher than 8.00（7.00,9.00）and 9.00（8.00,10.00）in group C,P<0.05;the patency time and survival time of high biliary obstruction in group B were 3.00（3.00,4.00）months and 4.00（4.00,5.00）months respectively,the patency time and survival time of low biliary obstruction were 3.00（3.00,4.00）months and 4.00（3.50,5.00）months respectively,which were significantly lower than the other three groups,the difference was statistically significant,P<0.05.The total complication rate of group A was lower than the other three groups,and the difference was statistically significant,P<0.05.Conclusion Endoscopic biliary drainage has a low complication rate in the treatment of malignant obstructive jaundice and has its unique advantages in the treatment of low-level biliary obstruction.In the management of high-level biliary obstruction,endoscopic stent drainage,percutaneous hepatobiliary stent drainage or combined local radiotherapy are all options.The simple percutaneous hepatobiliary puncture and drainage group has no obvious advantage in managing malignant biliary tract obstruction,and can be used as a supplementary method that cannot be performed by the other three methods.