Efficacy of percuteneous transhepatic cholangio drainage under digital subtraction angiography guided by ultrasound ultrasound in the treatment of advanced malignant obstructive jaundice
TANG Min;JIANG Ming-wei;WANG Hui;HUANG Lei;Department of General Surgery,Yangpu District Central Hospital of Shanghai;
Objective To explore the effect of efficacy of percuteneous transhepatic cholangio drainage( PTCD) under digital subtraction angiography( DSA) guided by ultrasound in the treatment of advanced malignant obstructive jaundice( MBOJ). Methods A retrospective study of 68 patients with MBOJ admitted to Yangpu District Central Hospital of Shanghai from February 2014 to October 2015 was conducted. According to the puncture way,patients were divided into group A and group B with 34 patients in each group.Group A was given DSA and PTCD guided by ultrasound. Group B underwent traditional ultrasound-guided PTCD. The flow of drainage,the position of the drainage tube,the liver function including aspertate aminotransferase( AST),alanine transaminase( ALT),and serum total bilirubin( TBL),and the treatment results including clinical data,survival rate,morbidity,and first pass yield rate. Results For group A,the internal and external drainage and the two-sided single tube which was higher than group B( all P 0. 05).After the surgery,the liver function index AST,ALT and TBL significantly decreased compared with before the surgery with group A lower than group B( all P 0. 05). The operation time and hemorrhage volume were significantly lower in group A than in group B and 1-year survival and first pass yield rate were higher in group A than in group B( all P 0. 05). There was no significant difference in complications between the two groups( P 0. 05). Conclusion DSA combined with ultrasound guided PTCD was superior to single ultrasound guidance with more excellent therapeutic efficacy. To improve the treatment efficacy,success rate of catheterization and survival rate should be improved.
【CateGory Index】： R730.5