恶性梗阻性黄疸的两种微创介入治疗术后并发症比较分析

Comparison of postoperative complication rate between two kinds of minimally invasive treatment for malignant obstructive jaundice

目的：对经ERCP放置胆道支架与经PTBD放置胆道支架两种途径解除恶性梗阻性黄疸术后并发症进行比较分析。方法回顾分析我院2008年1月-2013年12月通过介入途径治疗恶性梗阻性黄疸的128例患者,其中71例采用ERCP放置胆道内支架,57例采用PTBD放置胆道内支架,比较两种不同引流方式术后并发症情况。结果71例ERCP患者中,5例出现并发症,其中3例合并有ERCP术后胰腺炎,1例胆道出血,1例感染发热,并发症发生率为7.0%,57例PTBD患者中8例出现并发症,其中4例感染发热,2例出现出血,1例胆汁性腹膜炎,1例肝脓肿,并发症发生率为14.0%,两组比较差异具有统计学意义（P〈0.05）。结论经ERCP放置胆道内支架在减少术后并发症发生率方面更有意义。

Objective To compare the postoperative complication rate of two kinds of minimally invasive treatment for malignant obstructive jaundice relieved by stenting via endoscopic retrograde cholangiopancreatography （ERCP） or per-cutaneous transhepatic biliary drainage （PTBD）. Methods A total of 128 patients who had received ERCP or PTBD for the palliative treatment of malignant obstructive jaundice were retrospectively assessed in our hospital from January 2008 to December 2013. According to operation method, all the patients were divided into two groups. 71 patients treated by ERCP. 57 patients treated by PTBD. Investigated the different biliary drainage methods postoperative com-plication. Results Postoperative complication after ERCP occurred in five patients, including post-ERCP pancreatitis in three patients,hemobilia in one patient and fever in one patient, the rate of complication was 7.0%. Following the PTBD, eight patients （14.0%） suffered complications, fever was observed in four patients, self-limiting hemobilia in two pa tients, bile leakage in one patient, liver abscess in one patient. The postoperative complication rate of PTBD was higher than the ERCP group （P〈0.05）. Conclusion ERCP is feasible for palliation of malignant obstructive jaundice and seems to have a low rate of postoperative complication.