胆道支架与外科手术姑息性治疗恶性梗阻性黄疸的临床效果分析

Analysis of the Clinical Effect of Biliary Stent with Surgical Drainage to Palliative Treatment of Malignant Obstructive Jaundice

目的分析比较胆道支架与外科手术姑息性治疗恶性梗阻性黄疸的效果。方法选取不能行根治性手术切除的恶性梗阻性黄疸患者383例:298例为内镜下放置胆管支架行内引流(内镜组);85例为同期术前判断有手术切除可能而术中证实不能行根治性手术或者要求手术引流(手术组)。比较两组相应的观测值。结果两组直接胆红素下降50%的平均时间、死亡率均无统计学意义(P>0.05);与手术组相比,内镜组术后并发症、平均住院时间及住院费用均少于手术组(P<0.05)。结论对于恶性梗阻性黄疸的姑息性治疗,内镜下胆管支架引流具有微创、住院时间短、住院费用少等优势。

Objective To analyze the therapeutic effect of biliary stent and surgical drainage to palliative treatment of malignant obstructive jaundice.Methods A total of 383 patients with inoperable malignant obstructive jaundice were treated in our hospital,among which 298 patients had endoscopic drainage by biliary stent(endoscopic group);Simultaneously 85 patients were selected for operation by intra-external drainage(surgical group).Observation values were compared between the two group.Results There were no significant differences of the average time to 50% decrease of direct bilirubin or mortality rate between the two groups(P > 0.05).The postoperative complications,the average length of hospitalization,the average cost of hospitalization of endoscopic group were less than those of surgical group(P < 0.05).Conclusion For palliative treatment of malignant obstructive jaundice,endoscopic drainage has advantages of minimally invasive,reducing average length and average cost of hospitalization.