Bao Guanghe, Liu Huijun, Ma Yanshou, Li Nanlin, Lv Fengquan, Dong Xiangyuan, Chen Xianxia
Department of Interventional Radiography, Qinghai Provincial People's Hospital Xining 810007, Qinghai, China.
Department of Oncological Surgery, Qinghai Provincial People's Hospital Xining 810007, Qinghai, China.
Am J Transl Res. 2021 Jun 15;13(6):7400-7405. eCollection 2021.
To study the clinical efficacy and safety of different biliary drainages in malignant obstructive jaundice (MOJ) treatment.
69 patients with MOJ admitted to our hospital from October 2016 to March 2019 were recruited as the study cohort and divided into an endoscopic retrograde cholangiopancreatography group (the ERCP group, n=38) and a percutaneous transhepatic cholangial drainage group (the PTCD group, n=31) according to the different drainage approaches each patient underwent. We compared the two groups' hepatic function indexes (total serum bilirubin (TB), alanine aminotransferase (ALT), and aspartate aminotransferase (AST)), their immune cells (CD3+ T cells, CD4+ T cells, and CD8+ T cells), surgical success rates, jaundice reduction response rates, and postoperative complications.
The surgical success rates and the jaundice reduction response rates were similar in the two groups (P > 0.05). No statistically significant differences were observed in the hepatic function indexes or in the immune cells before and after treatment in the two groups (all P > 0.05). Moreover, all the indexes we measured were lower post-treatment than they were pre-treatment (TB, ALT, AST, and CD8+) except for the CD3+ and CD4+ levels (all P < 0.05). The incidence of postoperative complications in the ERCP group was significantly lower than the incidence in the PTCD group (P < 0.05).
Both ERCP and PTCD can contribute to better clinical results in the treatment of MOJ, relieve obstructions effectively, improve hepatic function, and enhance immune function, but there are fewer complications after ERCP.
研究不同胆道引流术在恶性梗阻性黄疸(MOJ)治疗中的临床疗效和安全性。
选取2016年10月至2019年3月我院收治的69例MOJ患者作为研究队列,根据每位患者接受的不同引流方法分为内镜逆行胰胆管造影术组(ERCP组,n = 38)和经皮经肝胆道引流组(PTCD组,n = 31)。比较两组的肝功能指标(总血清胆红素(TB)、丙氨酸氨基转移酶(ALT)和天冬氨酸氨基转移酶(AST))、免疫细胞(CD3 + T细胞、CD4 + T细胞和CD8 + T细胞)、手术成功率、黄疸减轻反应率和术后并发症。
两组的手术成功率和黄疸减轻反应率相似(P > 0.05)。两组治疗前后的肝功能指标或免疫细胞均未观察到统计学上的显著差异(所有P > 0.05)。此外,除CD3 +和CD4 +水平外,我们测量的所有指标在治疗后均低于治疗前(TB、ALT、AST和CD8 +)(所有P < 0.05)。ERCP组术后并发症的发生率显著低于PTCD组(P < 0.05)。
ERCP和PTCD在MOJ治疗中均能取得较好的临床效果,有效解除梗阻,改善肝功能,增强免疫功能,但ERCP术后并发症较少。