Clinical efficacy of different biliary decompression methods in the treatment of hepatic hilar cholangiocarcinoma
Objective To compare the clinical efficacy of percutaneous transhepatic cholangial drainage(PTCD)and endoscopic nasobili-ary drainage(ENBD)in treating jaundice caused by different types of hilar cholangiocarcinoma(HCCA),aiming to provide a reference for clinical treatment decisions.Methods A total of 113 HCCA patients admitted to Hanzhong 3201 Hospital from January 2020 to February 2021 were selected and assigned to a control group(n=53)and an observation group(n=60)according to the treatment method.Patients in the control group received ENBD treatment,while those in the observation group received PTCD treatment.The success rate of drainage,jaundice reduction,liver function,occurrence of complications,recurrence,and survival were compared be-tween the two groups.Results The success rate of type Ⅳ drainage and the overall success rate of drainage in the observation group were significantly higher than those in the control group[83.33％(10/12)vs.22.22％(2/9);95.00％(57/60)vs.75.47％(40/53);x2=5.546,8.830,P=0.019,0.003,respectively].The jaundice reduction rate in the observation group was significantly higher than that in the control group[83.33％(50/60)vs.50.94％(27/53);x2=13.599,P＜0.001].Before jaundice reduction surgery,no sig-nificant differences were noted in serum alkaline phosphatase(ALP),alanine aminotransferase(ALT),total bile acid(TBA),and γ-glutamyl transpeptidase(γ-GT)levels between the two groups(P＞0.05);after surgery,the levels of serum ALP,ALT,TBA,andγ-GT in both groups showed reductions,and the observation group had lower levels than the control group,with significant differences(P＜0.05).The incidence of complications in the control and observation groups was 9.43％(5/53)and 5.00％(3/60),respectively,with no significant difference(x2=0.302,P=0.583).The rates of distant metastasis recurrence in the control and observation groups were 26.42％(14/53)and 15.00％(9/60),respectively,and the 3-year survival rates were 16.98％(9/53)and 26.67％(16/60),re-spectively,with no significant differences(x2=2.262,1.532,P=0.133,0.215).Conclusion Compared with ENBD,PTCD has a higher drainage success rate in treating type Ⅳ HCCA,can effectively reduce γ-GT levels,promote jaundice reduction,and contribute to liver function recovery,with a higher safety profile,making it valuable for clinical application.
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