Robison R, Madura J, Scholten D, Lempke R, Rabe F, Glover J, Becker G, Cockerill E, Broadie T
Am Surg. 1984 Jun;50(6):329-33.
Percutaneous transhepatic drainage ( PTHD ) is an adjunct in the management of malignant biliary obstruction. It can be used for two purposes: as a palliative measure alone or as part of the preoperative preparation. This study assesses the efficacy of this technique. The charts of all patients undergoing PTHD were reviewed, and the data were collated according to the intent of catheterization. In the palliative group (18 patients), bilirubin levels fell from 20 +/- 1.8 to 10 +/- 1.9 mg/dl. PTHD complications developed in 14 (78%), the 1-month mortality was 56 per cent (10/18), and all of the patients have died (mean, 2.3 months). In the preoperative group (17 patients), bilirubin levels fell from 17 +/- 1.4 to 6 +/- 0.6 mg/dl, PTHD complications developed in three (18%), and postoperative complications occurred in five (30%). All patients in the preoperative group survived operation, 11 of 16 dying a mean of 4.5 months postoperatively. The five surviving patients have lived 2 to 25 months. The authors conclude that PTHD significantly lowers the serum bilirubin in both preoperative and palliative groups. In the preoperative group, its use is associated with low morbidity and may improve the patient's preoperative condition. In the palliative group, PTHD is associated with an appreciable morbidity that tempers the enthusiasm for its routine use in this circumstance.
经皮肝穿刺引流术（PTHD）是恶性胆管梗阻治疗中的一种辅助手段。它可用于两个目的：单独作为一种姑息性措施或作为术前准备的一部分。本研究评估了该技术的疗效。回顾了所有接受PTHD治疗患者的病历，并根据置管目的整理数据。在姑息治疗组（18例患者）中，胆红素水平从20±1.8降至10±1.9mg/dl。14例（78%）出现PTHD并发症，1个月死亡率为56%（10/18），所有患者均已死亡（平均2.3个月）。在术前组（17例患者）中，胆红素水平从17±1.4降至6±0.6mg/dl，3例（18%）出现PTHD并发症，5例（30%）出现术后并发症。术前组所有患者均存活至手术，16例中有11例术后平均4.5个月死亡。5例存活患者存活了2至25个月。作者得出结论，PTHD在术前组和姑息治疗组中均能显著降低血清胆红素水平。在术前组中，其使用与低发病率相关，可能改善患者的术前状况。在姑息治疗组中，PTHD与相当高的发病率相关，这削弱了在这种情况下对其常规使用的热情。
