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经皮经肝胆道引流+射频消融联合胆道支架植入术对胆管癌合并恶性梗阻性黄疸患者肝功能的影响

Effect of percutaneous transhepatic cholangial drainag + radiofrequency ablation combined with biliary stent implantation on the liver function of patients with cholangiocarcinoma complicated with malignant obstructive jaundice.

作者信息

Qi Shuangyu, Yan Huijun

机构信息

Department of Hepatobiliary and Pancreatic Surgery, Hengshui People's Hospital Hengshui, Hebei Province, China.

出版信息

Am J Transl Res. 2021 Mar 15;13(3):1817-1824. eCollection 2021.

Abstract

OBJECTIVE

To investigate the effect of percutaneous transhepatic cholangial drainage (PTCD) + radiofrequency ablation (RFA) combined with biliary stent implantation on the liver function of patients with cholangiocarcinoma complicated with malignant obstructive jaundice.

METHODS

Retrospective analysis of 120 patients with cholangiocarcinoma complicated with malignant obstructive jaundice were divided into the research group (n=60) and the control group (n=60) according to different treatments. The research group received PTCD + RFA combined with biliary stent implantation, while the control group received only PTCD combined with biliary stent implantation. The changes of liver function indexes before and after treatment, the condition of postoperative jaundice in different periods after operation, toxicity and survival time were observed.

RESULTS

There was no statistically significant difference between the two groups in general data (P>0.05). Before treatment, there was no statistically significant difference between the two groups in albumin (ALB), alkaline phosphatase (ALP), glutamyltranspeptidase (GGT), total bilirubin (TBil) and direct bilirubin (DBil) (all P>0.05). After treatment, the above indicators were all decreased (all P<0.05), and the patient's condition improved, but there was no significant difference between the research group and the control group (P>0.05). There were patients with postoperative jaundice in the two groups at 1 month, 3 months, and 6 months after surgery. The total incidence of postoperative jaundice in the research group and the control group within 6 months was 11.67% and 30.00%, respectively (P<0.05). After treatment, the aftereffects were observed in the research group (15.00%) and the control group (25.00%), including infection, cholangitis, and biliary bleeding, without statistical significance (P>0.05). There was no statistical significant difference in progression-free survival between the two groups (P>0.05), while patients in the research group had higher median survival and 1-year survival rates than those of the control group (both P<0.05).

CONCLUSION

After PTCD + RFA combined with biliary stent implantation was performed on the patients with cholangiocarcinoma complicated with malignant obstructive jaundice, the number of patients with postoperative jaundice at different time points was reduced; 1-year survival rate and median survival were increased; patents' liver function and condition were improved. Thus, this method is worthy of promotion and application.

摘要

目的

探讨经皮经肝胆道引流术(PTCD)+射频消融术(RFA)联合胆道支架植入术对胆管癌合并恶性梗阻性黄疸患者肝功能的影响。

方法

回顾性分析120例胆管癌合并恶性梗阻性黄疸患者,根据不同治疗方法分为研究组(n=60)和对照组(n=60)。研究组接受PTCD+RFA联合胆道支架植入术,对照组仅接受PTCD联合胆道支架植入术。观察治疗前后肝功能指标变化、术后不同时期黄疸情况、毒性反应及生存时间。

结果

两组一般资料比较,差异无统计学意义(P>0.05)。治疗前,两组白蛋白(ALB)、碱性磷酸酶(ALP)、谷氨酰转肽酶(GGT)、总胆红素(TBil)及直接胆红素(DBil)比较,差异无统计学意义(均P>0.05)。治疗后,上述指标均下降(均P<0.05),患者病情改善,但研究组与对照组比较,差异无统计学意义(P>0.05)。两组术后1个月、3个月及6个月均有黄疸患者。研究组和对照组术后6个月内黄疸总发生率分别为11.67%和30.00%(P<0.05)。治疗后,研究组(15.00%)和对照组(25.00%)出现不良反应,包括感染、胆管炎及胆道出血,差异无统计学意义(P>0.05)。两组无进展生存期比较,差异无统计学意义(P>0.05),而研究组患者的中位生存期和1年生存率均高于对照组(均P<0.05)。

结论

对胆管癌合并恶性梗阻性黄疸患者行PTCD+RFA联合胆道支架植入术后,不同时间点术后黄疸患者数量减少;1年生存率和中位生存期提高;患者肝功能及病情改善。因此,该方法值得推广应用。

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