Efficacy and influencing factors of percutaneous transhepatic cholangiography and biliary drainage in malignant obstructive jaundice patients.

Abstract

Objectives: To analyze the efficacy and influencing factors of percutaneous transhepatic cholangiography and biliary drainage (PTCD) in patients with malignant obstructive jaundice (MOJ).

Methods: The study included 151 MOJ patients admitted from January 2021 to January 2024. Seventy patients in the control group received endoscopic retrograde cholangiopancreatography (ERCP), while 81 patients in the research group underwent PTCD. Clinical outcomes, including surgical success rate, efficacy (overall remission, high- and low-level intestinal obstruction remission), safety (bile leakage, septicemia, hemobilia, pancreatitis, and gastrointestinal bleeding), and clinical-related indicators (hospital stay, surgical cost, treatment cost), as well as serum biochemical markers (alanine aminotransferase [ALT], direct bilirubin [DBIL], and total bilirubin [TBIL]), were compared between the groups. Binary logistic regression was used to identify factors influencing PTCD efficacy.

Results: The surgical success rate was significantly higher in the research group than that in the control group (P < 0.05). Although the overall remission rates were similar between the groups (P > 0.05), the research group had a lower low-level intestinal obstruction remission rate and a higher high-level intestinal obstruction remission rate (P < 0.05). Safety profiles and changes in pre- and post-operative serum biochemical markers did not differ significantly between the groups (all P > 0.05). The research group experienced longer hospital stays and lower surgical costs compared to the control group (both P < 0.05), while treatment costs were similar (P > 0.05). Binary logistic regression identified obstruction site, and preoperative liver dysfunction as factors influencing PTCD efficacy.

Conclusions: PTCD demonstrated a higher surgical success rate than ERCP in MOJ patients, with comparable overall efficacy, safety, and treatment costs. PTCD was associated with longer hospital stays and lower surgical costs. Both procedures similarly improved ALT, DBIL, and TBIL levels. PTCD showed the greatest therapeutic benefit in cases of high-level intestinal obstruction.