Abstract:
Objective To compare the clinical outcome of Endoscopic Nasobiliary Drainage(ENBD), Endoscopic Retrograde Biliary Drainage (ERBD) and Percutaneous Transhepatic Cholangial Drainage(PTCD) in the preoperative treatment of elderly patients with type Ⅲ~Ⅳ hilar cholangiocarcinoma.
Methods Clinical data of 66 elderly patients with type Ⅲ~Ⅳ hilar cholangiocarcinoma, who received preoperative biliary drainage from January 2013 to December 2018, were analyzed retrospectively. According to the different kinds of biliary drainage, patients were divided into PTCD group, ERBD group and ENBD group. All of 66 patients underwent radical resection of hilar cholangiocarcinoma. Statistical analysis were performed by using SPSS 20.0 software. Measurement data such as liver function indexs and perioperative indexs were expressed as mean±standard deviation and were examined by variance analysis. The incidence of complications were examined by chi square test. A P value of <0.05 was considered as statistically significant.
Results TBIL, AST, alt, ALP and GGT were significantly decreased in all of three groups after biliary drainage (P<0.05). There was no significant difference in terms of total incidence of complications and perioperative indexes among three groups (P>0.05), however only in PTCD group, there was no hepatoduodenal ligament edema.
Conclusion Preoperative PTCD is the best way to reduce jaundice in the elderly patients with type Ⅲ~Ⅳ hilar cholangiocarcinoma.
Key words:
Bile duct neoplasms,
Jaundice,
Comparative effectiveness research,
Percutaneous Transhepatic Cholangial Drainage (PTCD),
Endoscopic Retrograde Biliary Drainage (ERBD),
Endoscopic Nasobiliary Drainage (ENBD)
Guanghui Li, Kanyu Yao, Haiping Zhao, Feifei Lyu. Clinical analysis of preoperative biliary drainage for elderly patients with Ⅲ~Ⅳ hilar cholangiocarcinoma[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2019, 13(06): 556-559.