|本期目录/Table of Contents|

[1]张银,张悦,陈炳芳,等.超声内镜引导与经皮肝穿刺胆道引流应用于梗阻性黄疸患者的疗效评价[J].医学研究与战创伤救治(原医学研究生学报),2022,24(2):133-137.[doi:10.3969/j.issn.1672-271X.2022.02.005]
　ZHANG Yin,ZHANG Yue,CHEN Bing-fang,et al.Evaluation of endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage in patients with obstructive jaundice[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2022,24(2):133-137.[doi:10.3969/j.issn.1672-271X.2022.02.005]
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超声内镜引导与经皮肝穿刺胆道引流应用于梗阻性黄疸患者的疗效评价()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第24卷
期数:
2022年2期
页码:
133-137
栏目:
临床研究
出版日期:
2022-03-20

文章信息/Info

Title:
Evaluation of endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage in patients with obstructive jaundice
作者:
张银; 张悦; 陈炳芳; 孙克文; 王莉; 陈建平; 汤美; 丁炎波
作者单位：213003常州，苏州大学附属第三医院（常州市第一人民医院）消化内科（张银、陈炳芳、孙克文、王莉、陈建平、汤美、丁炎波），肝胆胰外科（张悦）
Author(s):
ZHANG Yin; ZHANG Yue; CHEN Bing-fang; SUN Ke-wen; WANG Li; CHEN Jian-ping; TANG Mei; DING Yan-bo
(1.Department of Gastroenterology, 2.Department of Hepatopancreatobiliary Surgery, the Third Affiliated Hospital of Soochow University/the First People’s Hospital of Changzhou, Changzhou 213003, Jiangsu, China)
关键词:
梗阻性黄疸; 内镜逆行胰胆管造影术; 超声内镜引导下胆道引流术; 经皮肝穿刺胆道引流术
Keywords:
obstructive jaundice;  endoscopic retrograde cholangiopancreatography;  endoscopic ultrasound-guided biliary drainage;  percutaneous transhepatic biliary drainage
分类号:
R657.4
DOI:
10.3969/j.issn.1672-271X.2022.02.005
文献标志码:
A
摘要:
目的对比超声内镜引导下胆道引流术(EUS-BD)与经皮肝穿刺胆道引流术(PTBD)两种方法对于内镜逆行胰胆管造影术(ERCP)失败的梗阻性黄疸患者的疗效。方法回顾性分析2015年9月至2021年3月在常州市第一人民医院行ERCP失败后行EUS-BD的29例梗阻性黄疸患者（EUS-BD组）临床资料，随机选取相同时间段、相同适应证的接受PTBD的30例梗阻性黄疸患者纳入PTBD组。比较两种方法的技术成功率、临床有效率、并发症、术后1个月内再干预率和术后住院时间。结果EUS-BD组中，25例患者获得技术成功(86.2%)，其中25例临床有效(100%)；PTBD组中，28例患者获得技术成功(93.3%)(P>0.05)，其中25例临床有效(89.3%)(P>0.05)；2组技术成功率和临床有效率比较，差异无统计学意义(P>0.05)。EUS-BD组并发症发生率16.0%，PTBD组为28.6%,差异无统计学意义(P>0.05)。干预率EUS-BD组显著低于PTBD组(4.2%vs25.0%,P<0.05)。EUS-BD组术后住院时间为(13.6±7.8)d，PTBD组为(12.8±8.4)d,差异无统计学意义(P>0.05)。结论EUS-BD与PTBD均能有效缓解ERCP失败的梗阻性黄疸，两者相比操作成功率、临床有效率及并发症发生率均相当，但EUS-BD短期再干预率较低，其中腔内胆道引流联合EUS引导顺行胆汁引流术（EUS-AG）能更有效地缓解黄疸，可作为ERCP失败的梗阻性黄疸患者的一线治疗方案。
Abstract:
ObjectiveTo compare the effectiveness of endoscopic ultrasound-guided biliary drainage (EUS-BD) and percutaneous transhepatic biliary drainage (PTBD) in patients with obstructive jaundice after failed endoscopic retrograde cholangiopancreatography (ERCP).MethodsFrom September 2015 to March 2021, 59 patients undergoing obstructive jaundice receiving EUS-guided or percutaneous biliary drainage were enrolled in this study, including 29 cases in EUS-BD group and 30 cases in PTBD group. Technical success, clinical success, complications, re-intervention rate and postoperative hospital stay were compared.ResultsIn EUS-BD group, 25 patients achieved technical success (86.2%), of which 25 patients were clinically effective (100%). In PTBD group, 28 patients achieved technical success (93.3%) (P>0.05), of which 25 patients were clinically effective (89.3%)(P>0.05). The technical success and clinical success rates had no significantly different (P>0.05). The incidence of complications in the two groups was 16.0% and 28.6%, respectively (P>0.05). The short-term re-intervention rate in EUS-BD group was significantly lower than that in PTBD group (4.2% vs 25.0%, P<0.05). Postoperative hospital stay was (13.6±7.8) days in EUS-BD group and (12.8±8.4) days in PTBD group (P>0.05).ConclusionEUS-BD and PTBD can both effectively relieve the obstructive jaundice. The technical success, clinical effective rate and complication rate in the two groups were comparable. However, the short-term re-intervention rate in EUS-BD group was lower. Endoscopic hepaticogastrostomy with endoscopic antegrade stenting (EUS-AG) can relieve jaundice more effectively, and can be used as the first-line treatment for patients with obstructive jaundice after ERCP failure.

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备注/Memo

备注/Memo:
基金项目：常州市卫生健康青苗人才培养工程资助(CZQM2020017)
更新日期/Last Update: 2022-04-18