术前PTBD对肝门部胆管癌的疗效及安全性分析

The effect and safety of preoperative PTBD for hilar cholangiocarcinoma

目的探讨术前下经皮经肝胆管穿刺置管引流术(PTBD)对拟行手术治疗的肝门部胆管癌患者的疗效及安全性。方法选择2006年1月至2016年12月行手术治疗的肝门部胆管癌患者56例,其中PTBD组32例,对照组为24例没有实施PTBD患者,比较两组患者围手术期有关指标的变化情况。结果 PTBD组引流前后总胆红素分别为286±134 umol/L、153±96 umol/L,引流后胆红素比引流前下降,差别有统计学意义(P<0.05);而两组在术中出血量、胆汁细菌感染率、术后并发症等差别无统计学差异。结论术前PTBD对于黄疸较严重的肝门部胆管癌患者,能有效的减轻黄疸,是一种安全可行的办法,能有效改善肝功能,增强患者体质,增加手术耐受力。

Objective To investigate the effect and safety of preoperative percutaneous transhe-patic biliary drainage(PTBD)for the patients with hilar cholangiocarcinoma underwent operative treat-ment. Methods A total of 56 patients with hilar cholangiocarcinoma underwent operative treatmentbetween January 2006 and December 2016,in whom 32 patients were subjected to PTBD before surgery(PTBD group)and 24 patients without PTBD were assigned to controls. The changes of the perioperativeindicators were compared between two groups of patients. Results The total bilirubin of PTBD groupwas 286±134 umol/L before PTBD treatment,which was significantly reduced to 153±96 μmol/L aftertreatment(P<0.05). Moreover there was no significant difference of the incidence with blood lossintraoperative,the bacteria infection of bile and postoperative complications between the two groups.Conclusion PTBD is a safe and effective method to alleviate jaundice for the patients with hilar cholan-giocarcinoma before operation,which can improve the patients liver function,systemic general situationand the tolerance of the surgery.