133 Effect of Different Biliary Drainage Methods in Treatment of Malignant High Biliary Obstruction

Objective To explore the correlation of different biliary drainage methods with curative effect in the treatment of malignant high biliary obstruction(MHBO).

Methods A retrospective investigation was performed in 164 patients diagnosed as MHBO in the Fourth Hospital of Hebei Medical University. Among them, 18 cases received complete external drainage of biliary tract(group A), 48 cases received biliary single stent implantation combined with lateral drainage(group B), 34 cases received external drainage of biliary tract(group C), and 64 cases received biliary double stent implantation(group D). The short-term and long-term therapeutic evaluations as well as the postoperative complications were observed.

Results The differences in ALT, AST, TBIL and DBIL of all patients before operation and the 3rd, 7th, 14th day after operation were significant (P<0.05); on the 7th day, the decreased degree in the levels of ALT, AST, TBIL and DBIL in group A, B, D were higher than those in group C (P<0.05); on the 14th day, the decreased degree in the levels of ALT, AST, TBIL and DBIL in group D were higher than those in the other three groups, while they were higher in group B compared with group A and C, higher in group A than in group C (all P<0.05); on the 21st day, the decreased degree in the level of TBIL in group D was higher than those in the other three groups, while it was higher in group B compared with group A and C, higher in group A than in group C (all P<0.05). The postoperative median survival time of group D(355.00±22.21)days was obviously longer than the other three groups (P<0.05). C onclusion Reasonable drainage method can significantly improve the symptoms of the patients with malignant high biliary obstruction. Biliary double stent implantation can achieve adequate internal drainage, which has obvious advantages in rapid elimination of jaundice, and it is worthy of clinical promotion.