Objective: To explore the clinical value of ultrasonography combined with percutaneous transhepatic cholangial drainage(PTCD)in the treatment of low grade malignant obstructive jaundice. Methods: According to different treatment methods,135 patients with low grade malignant obstructive jaundice were divided into the group of ultrasound localization combined with percutaneous transhepatic bile-duct drainage(PTBD group) 52 cases, the group of ultrasound localization combined with percutaneous transhepatic gallbladder drainage(PTGD group) 46 cases and the group of endoscopic nasobiliary drainage(ENBD group) 37 cases. The differences in the number of catheterization, operation time, operation success rate, effective catheterization time, postoperative drainage volume, complications, liver function index and intrahepatic bile duct diameter before and after surgery were compared in each group. Results: Compared with the ENBD group, patients in the PTGD group and PTBD group had fewer catheterization times(P<0.05),shorter operative time(P<0.05),higher success rate of operation(P<0.05),longer postoperative effective catheterization time(P<0.05),smaller postoperative bile duct diameter(P<0.05),and lower postoperative complication rate(P<0.05).There was no difference in postoperative daily bile drainage volume and liver function index among ENBD group, PTGD group and PTBD group(P>0.05).Compared with PTBD group, the PTGD group showed less catheterization times(P<0.05),shorter operative time(P<0.05),and the PTBD group showed longer effective catheterization time than PTGD group(P<0.05). Conclusion: Ultrasound localization combined with PTCD in the treatment of low grade malignant obstructive jaundice has advantages of simple operation, high success rate of operation and few complications. PTBD can prolong postoperative effective catheterization time and is more suitable for palliative treatment of low grade malignant obstructive jaundice. |
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