中国内镜杂志2026，Vol.32Issue(8)：46-53,8.DOI:10.12235/E20260065
ERCP与PTCD对局部晚期或转移性胰腺癌合并恶性梗阻性黄疸患者姑息性化疗启动时间的影响
Impact of ERCP versus PTCD on time to initiation of palliative chemotherapy in patients with locally advanced or metastatic pancreatic cancer with malignant obstructive jaundice
章琼丹 1邵金海 2王翔 3戴烨枫 4蔡小泥4
作者信息
- 1. 海南医科大学 第一临床医学院,海南 海口 570100
- 2. 绍兴市上虞人民医院 重症医学科,浙江 绍兴 312300
- 3. 山东省立第三医院 肝胆外科,山东 济南 250000
- 4. 绍兴市上虞人民医院 普通外科,浙江 绍兴 312300
- 折叠
摘要
Abstract
Objective Investigating the impact of endoscopic retrograde cholangiopancreatography(ERCP)versus percutaneous transhepatic cholangial drainage(PTCD)on time to initiation of palliative chemotherapy in patients with locally advanced or metastatic pancreatic cancer with malignant obstructive jaundice(MOJ).Methods Retrospective analysis of clinical data from patients with locally advanced or metastatic pancreatic cancer complicated by MOJ treated at two hospitals between January 2021 and April 2025:a total of 58 cases including 12 from Shangyu People's Hospital of Shaoxing and 46 from Shandong Provincial Third Hospital were divided into the ERCP group(n=35)and PTCD group(n=23)according to different treatment methods.The study analyzed the duration of obstructive jaundice,time to achieve target events(Event I:total bilirubin≤1.8 mg/dL;Event II:≤2.5 mg/dL;Event III:≤5.0 mg/dL),palliative chemotherapy status,chemotherapy regimens,and incidence of complications between the two groups.Results Postoperative total bilirubin levels continued to decrease in both groups,with a faster rate of decrease observed in the ERCP group compared to the PTCD group[median total bilirubin:2.0(1.4,2.9)mg/dL and 2.8(1.9,4.1)mg/dL],the difference was statistically significant(P<0.05).There were no statistically significant differences in the proportions of patients achieving target event I and target event II between the two groups(P>0.05).However,the proportion of patients achieving target event III was significantly higher in the ERCP group compared to the PTCD group,with a statistically significant difference(P=0.015).Overall,79.31％(46/58)of patients received palliative chemotherapy during tumor treatment and 41.30％(19/46)of patients were treated with gemcitabine monotherapy as the standard treatment regimen.No statistically significant difference was observed in the incidence of complications between the two groups(P=0.138).Conclusion Both ERCP and PTCD are effective therapeutic modalities for reducing total bilirubin levels in patients with MOJ,with comparable complication rates.However,ERCP enables faster reduction of total bilirubin,thereby facilitating earlier initiation of palliative chemotherapy and prolonging survival.关键词
内镜逆行胰胆管造影术(ERCP)/恶性梗阻性黄疸(MOJ)/经皮经肝胆管穿刺引流术(PTCD)/胰腺癌Key words
endoscopic retrograde cholangiopancreatography(ERCP)/malignant obstructive jaundice(MOJ)/percutaneous transhepatic cholangial drainage(PTCD)/pancreatic cancer分类
医药卫生引用本文复制引用
章琼丹,邵金海,王翔,戴烨枫,蔡小泥..ERCP与PTCD对局部晚期或转移性胰腺癌合并恶性梗阻性黄疸患者姑息性化疗启动时间的影响[J].中国内镜杂志,2026,32(8):46-53,8.
