Abstract:
ObjectiveTo compare the clinical value and prognostic factors between ultrasound-guided percutaneous transhepatic cholangial drainage(PTCD) and percutaneous transhepatic biliary stent(PTBS) in the treatment of malignant obstructive jaundice(MOJ).
MethodsThe clinical data of the MOJ patients treated with palliative care in The First Affiliated Hospital of Bengbu Medical College from May 2014 to March 2018 were retrospectively analyzed, and divided into PTCD group and PTBS group according to the different treatment methods.The improvement of liver function, changes of neutrophil-lymphocyteratio(NLR), platelet-lymphocyte ratio(PLR) and monocyte-lymphocyte ratio(MLR), complications and postoperative survival situation were analyzed in two groups.The influencing factors of postoperative overall survival(OS) in two groups were analyzed using Kaplan-Meier curves and Cox proportional hazard model.
ResultsA total of 69 patients were investigated, which included 30 cases in PTCD group and 39 cases in PTBS group, 36 males and 33 females, and aged(70.7±5.6) years.The levels of ALT, AST, TBil and DBil in two groups after 1 month of operation significantly decreased compared before operation(P < 0.05).Compared with the PTCD group, the levels of DBIL, NLR, MLR and PLR in PTBS group after 1 month of operation significantly decreased(P < 0.01), and the better postoperative survival in the PTBS group was found(P < 0.05).There was no statistical significance in the postoperative complications between two groups(P>0.05).The results of Cox multivariate proportional hazard model showed that the higher preoperative TBiL, MLR and CA19-9 were the independent risk factors of influencing the prognosis of patients, and the PTBS treatment was an independent protective factor.
ConclusionsCompared with PTCD alone, PTBS can improve the prognosis and prolong the survival time of MOJ patients.Preoperative higher TBiL, MLR, and CA19-9 are the independent risk factors of influencing the prognosis of patients.
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