The impact of ERCP biliary stent implantation on immune inflammatory response and liver function in elderly patients with malignant obstructive jaundice
Objective To explore the clinical effect and possible action mechanism of endoscopic retrograde cholangiopancre-atography(ERCP)biliary stent implantation in elderly patients with malignant obstructive jaundice(MOJ).Methods Clinical data of 102 elderly patients with MOJ from July 2020 to June 2022 were collected.According to the placement method of biliary stent,the patients were divided into an ERCP group(n=54)and a percutaneous transhepatic cholangiodrainage(PTCD)group(n=48).The success rate of operation,clinical curative effect,cellular immune function,inflammatory factors,liver function and adverse reaction were compared between two groups.Results The low obstruction operation success rate and clinical curative effect in the ERCP group were higher than those in the PTCD group(χ2 =4.193 and 4.877,P<0.05).The levels of CD3+,CD4+ and CD4+/CD8+ were higher while CD8+ was lower in the ERCP group than those in the PTCD group(P<0.05).Serum levels of C-reactive protein(CRP),inter-leukon-6(IL-6)and tumor necrosis factor α(TNF-α)in the ERCP group were lower than those in the PTCD group(P<0.05).Serum levels of AST,ALT,Tbil and Dbil in the ERCP group were lower than those in the PTCD group(P<0.05).The complications such as catheter obstruction in the ERCP group was 7.41%that was lower than 22.92%in the PTCD group(χ2 =4.873,P<0.05).Conclusions ERCP biliary stent implantation can improve surgical effect and reduce complications.It may be related to the regulation of cellular immune function,inhibition of inflammatory reaction and improvement of liver function.
Malignant obstructive jaundiceBiliary stent placementEndoscopic retrograde cholangiopancreatographyImmune inflammatory responseLiver function
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