Significance of the MELD scoring system in surgical treatment of obstructive jaundice
10.3760/cma.j.issn.1007-8118.2014.07.007
- VernacularTitle:终末期肝病模型评分在梗阻性黄疸外科治疗中的意义
- Author:
Zhenlong WANG
;
Yong YU
;
Boyi CHEN
;
Chencai LI
;
Rong LI
- Publication Type:Journal Article
- Keywords:
Model for end-stage liver disease (MELD);
Percutaneoces transhepatic cholangial drainage (PTCD);
Obstructive jaundice;
Surgery treatment
- From:
Chinese Journal of Hepatobiliary Surgery
2014;20(7):503-506
- CountryChina
- Language:Chinese
-
Abstract:
Objective To prospectively study the clinical significance of the MELD scoring system in surgical treatment of obstructive jaundice.Methods 112 patients with obstructive jaundice who were admitted into our hospital from January 2009 to December 2013 were divided into two groups:group A (Stage Ⅰ PTCD and stage Ⅱ open operation,n =53) and group B (1 stage open surgery,n =59).The amount of intraoperative bleeding blood loss,operation time,postoperative complications,duration of hospitalization,mortality rate,and the changes in liver function after surgery were compared between the two groups.Results The differences in the liver function index of the two groups on the same postoperative date were significantly different (P ＜ 0.05).The liver function of group A recovered faster than group B.Patients in group A with a MELD ＜ 10 points stayed in hospital significantly longer when compared with patients in group B.For patients in group A with MELD ＞ 10 points,the operation time,bleeding volume,postoperative complications and hospitalization were significantly less than the patients in group B (P ＜ 0.05).There were 3 patients (group B) who died with MELD ≥ 20 points after operation.Conclusions In patients with obstructive jaundice with a MELD score greater than 10 points,especially those with a score equal to or greater than 20,PTCD should be performed first to relieve biliary tract obstruction,followed by a stage Ⅱ open surgical operation after the liver function had improved.MELD had important clinical significance in the evaluation of operation risk in patients with obstructive jaundice.
