ERCP与PTCD胆道金属支架置入术治疗低位恶性阻塞性黄疸的效果比较

Comparison of ERCP and PTCD for Biliary Metal Stent Placement in Treatment of Low Malignant Obstructive Jaundice

目的比较经内镜逆行胰胆管造影术(ERCP)与经皮肝穿刺胆道引流术(PTCD)胆道金属支架置入术治疗低位恶性阻塞性黄疸的临床效果。方法将123例低位恶性阻塞性黄疸患者按手术方式的不同分为治疗组(n=62)和对照组(n=61)。治疗组行ERCP胆道金属支架置入术,对照组行PTCD胆道金属支架置入术。观察2组手术成功率、黄疸缓解率和住院时间、住院费用及术后并发症发生率。结果治疗组手术成功率、黄疸缓解率分别为95.16%、93.55%,均高于对照组的83.61%、80.33%,差异均有统计学意义(均P<0.05)。治疗组住院时间短于对照组,住院费用低于对照组,差异均有统计学意义(均P<0.05)。治疗组术后总并发症发生率为4.84%,低于对照组的22.95%,差异有统计学意义(P<0.05)。结论对低位恶性阻塞性黄疸患者采用ERCP胆道金属支架置入术治疗可获得显著的效果。

Objective To compare of clinical effects of endoscopic retrograde cholangiopancreatography(ERCP)-and percutaneous transhepatic cholangial drainage(PTCD)-guided biliary metal stent placement on low malignant obstructive jaundice.Methods A total of 123 patients with low malignant obstructive jaundice were assigned to receive either ERCP(treatment group,n=62)or PTCD(control group,n=61)for biliary metal stent placement.The success rate of operation,remission rate of jaundice,hospital stay,hospitalization costs and incidence of postoperative complications were observed in both groups.Results The success rate of operation and remission rate of jaundice in treatment group(95.16%and 93.55%,respectively)were higher than those in control group(83.61%and 80.33%,respectively)(P<0.05).In addition,hospital stay and hospitalization costs were decreased compared with control group(P<0.05).The total incidence of postoperative complications in treatment group(4.84%)was lower than that in control group(22.95%)(P<0.05).Conclusion ERCP-guided biliary metal stent placement is effective for low malignant obstructive jaundice.