摘要
Abstract
Objective To explore the clinical effect of PTCD remedial therapy after ERCP failure in elderly patients with malignant obstructive jaundice (MOJ). Methods A total of 53 elderly patients with MOJ who initiated PTCD treatment after ERCP failure were selected (research group), and 46 elderly patients with MOJ who preferred PTCD treatment in the same period were selected (control group). Clinical symptoms and liver function changes, surgical success rate, incidence of postoperative complications and mortality rate between two groups were retrospectively analyzed. Results In research group, the main reason for ERCP failure was tumor caused severe stenosis of the bile duct (accounted for 67.9%), which could not be passed by the guide wire. PTCD was performed after ERCP failure, the operation success rate was 94.3%, with no statistical difference compared with control group (χ2=0.135, P=0.714). The complication rate in research group was 30.0%, slightly higher than that in control group (24.4%) (χ2=0.368, P=0.544). Due to tumor invasion, the success rate of biliary stent implantation in research group was significantly lower than that in control group(35.8% vs 69.6%, χ2=11.208, P=0.001).After two weeks, clinical symptoms and liver function indicators in research group were significantly better than those before operation (P<0.01). Two groups had the same effects of reducing jaundice. No deaths was found. Conclusion After ERCP failure in elderly patients with MOJ, PTCD remedial treatment is put in effect, and the success rate, complication rate and mortality are not different from the preferred PTCD treatment. This operation is worthy of clinical reference.关键词
黄疸,阻塞性/胰胆管造影,内镜逆行/经皮肝穿刺胆道引流术Key words
obstructive jaundice/endoscopic retrograde cholangiopancreatography/percutaneous transhe-patic cholangial drainage分类
医药卫生
