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Abstract：
BACKGROUND: Malignant obstructive jaundice (MOJ) is a condition characterized by varying degrees of bile duct stenosis and obstruction, accompanied by the progressive development of malignant tumors, leading to high morbidity and mortality rates. Currently, the two most commonly employed methods for its management are percutaneous transhepatic bile duct drainage (PTBD) and endoscopic ultrasound-guided biliary drainage (EUS-BD). While both methods have demonstrated favorable outcomes, additional research needs to be performed to determine their relative efficacy.
OBJECTIVE: To compare the therapeutic effectiveness of EUS-BD and PTBD in treating MOJ.
METHODS: This retrospective analysis, conducted between September 2015 and April 2023 at The Third Affiliated Hospital of Soochow University (The First People\'s Hospital of Changzhou), involved 68 patients with MOJ. The patients were divided into two groups on the basis of surgical procedure received: EUS-BD subgroup (n = 33) and PTBD subgroup (n = 35). Variables such as general data, preoperative and postoperative indices, blood routine, liver function indices, myocardial function indices, operative success rate, clinical effectiveness, and complication rate were analyzed and compared between the subgroups.
RESULTS: In the EUS-BD subgroup, hospital stay duration, bile drainage volume, effective catheter time, and clinical effectiveness rate were superior to those in the PTBD subgroup, although the differences were not statistically significant (P > 0.05). The puncture time for the EUS-BD subgroup was shorter than that for the PTBD subgroup (P < 0.05). Postoperative blood routine, liver function index, and myocardial function index in the EUS-BD subgroup were significantly lower than those in the PTBD subgroup (P < 0.05). Additionally, the complication rate in the EUS-BD subgroup was lower than in the PTBD subgroup (P < 0.05).
CONCLUSIONS: EUS-BD may reduce the number of punctures, improve liver and myocardial functions, alleviate traumatic stress, and decrease complication rates in MOJ treatment.
OBJECTIVE: To compare the therapeutic effectiveness of EUS-BD and PTBD in treating MOJ.
METHODS: This retrospective analysis, conducted between September 2015 and April 2023 at The Third Affiliated Hospital of Soochow University (The First People\'s Hospital of Changzhou), involved 68 patients with MOJ. The patients were divided into two groups on the basis of surgical procedure received: EUS-BD subgroup (n = 33) and PTBD subgroup (n = 35). Variables such as general data, preoperative and postoperative indices, blood routine, liver function indices, myocardial function indices, operative success rate, clinical effectiveness, and complication rate were analyzed and compared between the subgroups.
RESULTS: In the EUS-BD subgroup, hospital stay duration, bile drainage volume, effective catheter time, and clinical effectiveness rate were superior to those in the PTBD subgroup, although the differences were not statistically significant (P > 0.05). The puncture time for the EUS-BD subgroup was shorter than that for the PTBD subgroup (P < 0.05). Postoperative blood routine, liver function index, and myocardial function index in the EUS-BD subgroup were significantly lower than those in the PTBD subgroup (P < 0.05). Additionally, the complication rate in the EUS-BD subgroup was lower than in the PTBD subgroup (P < 0.05).
CONCLUSIONS: EUS-BD may reduce the number of punctures, improve liver and myocardial functions, alleviate traumatic stress, and decrease complication rates in MOJ treatment.
摘要：
背景：恶性梗阻性黄疸（MOJ）是一种以不同程度的胆管狭窄和阻塞为特征的疾病，伴随着恶性肿瘤的进行性发展，导致高发病率和死亡率。目前,两种最常用的治疗方法是经皮肝穿刺胆管引流术(PTBD)和内镜超声引导胆道引流术(EUS-BD).虽然这两种方法都显示出良好的结果，需要进行额外的研究以确定其相对疗效.
目的：比较EUS-BD和PTBD治疗MOJ的疗效。
方法：本回顾性分析，2015年9月至2023年4月在苏州大学附属第三医院（常州市第一人民医院）进行，涉及68名MOJ患者。根据所接受的手术方式将患者分为两组：EUS-BD亚组（n=33）和PTBD亚组（n=35）。一般数据等变量，术前和术后指标，血常规,肝功能指标,心肌功能指标，手术成功率,临床有效性，分析比较各组间并发症发生率。
结果：在EUS-BD亚组，住院时间,胆汁引流量,导管有效时间,临床有效率优于PTBD亚组，差异无统计学意义(P>0.05)。EUS-BD亚组的穿刺时间短于PTBD亚组(P<0.05)。术后血常规,肝功能指标,EUS-BD亚组心肌功能指标明显低于PTBD亚组(P<0.05)。此外,EUS-BD亚组并发症发生率低于PTBD亚组(P<0.05)。
结论：EUS-BD可以减少穿刺次数，改善肝脏和心肌功能，缓解创伤压力，并降低MOJ治疗中的并发症发生率。
目的：比较EUS-BD和PTBD治疗MOJ的疗效。
方法：本回顾性分析，2015年9月至2023年4月在苏州大学附属第三医院（常州市第一人民医院）进行，涉及68名MOJ患者。根据所接受的手术方式将患者分为两组：EUS-BD亚组（n=33）和PTBD亚组（n=35）。一般数据等变量，术前和术后指标，血常规,肝功能指标,心肌功能指标，手术成功率,临床有效性，分析比较各组间并发症发生率。
结果：在EUS-BD亚组，住院时间,胆汁引流量,导管有效时间,临床有效率优于PTBD亚组，差异无统计学意义(P>0.05)。EUS-BD亚组的穿刺时间短于PTBD亚组(P<0.05)。术后血常规,肝功能指标,EUS-BD亚组心肌功能指标明显低于PTBD亚组(P<0.05)。此外,EUS-BD亚组并发症发生率低于PTBD亚组(P<0.05)。
结论：EUS-BD可以减少穿刺次数，改善肝脏和心肌功能，缓解创伤压力，并降低MOJ治疗中的并发症发生率。
