A multicenter study on the efficacy of percutaneous transhepatic cholangial drainage and endoscopic retrograde cholagiopancreatography for acute obstructive suppurative cholangitis
10.3760/cma.j.cn113884-20230607-00161
- VernacularTitle:PTCD与ERCP治疗急性梗阻性化脓性胆管炎的多中心疗效对比分析
- Author:
Lili ZHANG
1
;
Lei GONG
;
Lei WANG
;
Yingwei ZHU
Author Information
1. 无锡市第二人民医院（江南大学附属中心医院）消化内科，无锡 214000
- Keywords:
Cholangitis;
Percutaneous transhepatic cholangial drainage;
Endoscopic retrograde cholangiopancreatography
- From:
Chinese Journal of Hepatobiliary Surgery
2023;29(9):659-663
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the efficacy of percutaneous transhepatic cholangial drainage (PTCD) and endoscopic retrograde cholangiopancreatography (ERCP) for acute obstructive suppurative cholangitis (AOSC).Methods:Clinical data of 63 patients with AOSC admitted to Wuxi No.2 People’s Hospital and the Affiliated Drum Tower Hospital of Nanjing University Medical School from January 2018 to December 2022 were retrospectively analyzed, including 38 males and 25 females, aged (72.0±13.9) years. According to the treatment modality, patients were divided into PTCD group ( n=30) and ERCP group ( n=33). The laboratory data of inflammation and liver function, clinical effect and survival were compared between the groups. Results:The white blood cell count, neutrophil ratio, serum levels of C-reactive protein, procalcitonin, glutamic oxaloacetic transaminase, glutamic-pyruvic transaminase, and glutamyl transpeptidase in both groups decreased significantly at seven days after the procedures, compared to those before treatment (all P<0.05). The postoperative levels of total bilirubin and direct bilirubin in the ERCP group were significantly lower than those in the PTCD group [48.6 (35.0, 99.5) vs 34.5 (24.4, 69.5) μmol/L, ( Z=1.97, P=0.047) and 102.0 (37.5, 108.0) vs 77.0 (22.0, 115.6) μmol/L, ( Z=2.11, P=0.036)]. The levels of total bilirubin ( Z=4.06, P<0.001) and direct bilirubin ( Z=3.47, P<0.001) were significantly decreased after ERCP, compared to those before the treatment. There was no significant difference in the total effective rate and survival between the groups (both P>0.05). Conclusion:Both PTCD and ERCP can effectively alleviate biliary obstruction and inflammatory reaction and enhance the recovery of liver function. ERCP could better relieve the jaundice.
