Application of preoperative biliary drainage in malignant low obstructive jaundice

YAO Feng; YOU Jian

doi:10.14188/j.1671-8852.2025.0281

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Application of preoperative biliary drainage in malignant low obstructive jaundice

更新时间：2026-11-05

- Application of preoperative biliary drainage in malignant low obstructive jaundice
- Medical Journal of Wuhan University Vol. 46, Issue 9, Pages: 1185-1189(2025)
- 作者机构：
  
  武汉市第四医院普外科湖北武汉 430033
- 作者简介：
- 基金信息：
- DOI：10.14188/j.1671-8852.2025.0281
  CLC： R730.56
- Received：25 March 2025，
  
  Published：26 September 2025
- 稿件说明：
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姚丰,游建.术前减黄在恶性低位梗阻性黄疸中的应用[J].武汉大学学报（医学版）,2025,46(09):1185-1189.

YAO Feng,YOU Jian.Application of preoperative biliary drainage in malignant low obstructive jaundice[J].Medical Journal of Wuhan University,2025,46(09):1185-1189.
姚丰,游建.术前减黄在恶性低位梗阻性黄疸中的应用[J].武汉大学学报（医学版）,2025,46(09):1185-1189. DOI： 10.14188/j.1671-8852.2025.0281.

YAO Feng,YOU Jian.Application of preoperative biliary drainage in malignant low obstructive jaundice[J].Medical Journal of Wuhan University,2025,46(09):1185-1189. DOI： 10.14188/j.1671-8852.2025.0281.

摘要

目的

探讨不同术前减黄方式在恶性低位梗阻性黄疸中的减黄效果，并总结临床经验。

方法

本研究采用回顾性队列研究方法，收集2019年1月至2024年12月在同一中心接受术前减黄治疗，择期行胰十二指肠切除术的76例恶性低位梗阻性黄疸患者的临床资料。根据术前减黄方式将患者分为两组：内镜下逆行胰胆管造影（ERCP）支架植入组（

=41），接受内镜逆行胰胆管造影下胆道支架置入术；经皮肝胆管穿刺引流（PTCD）组（

=35），接受经皮经肝胆道穿刺引流术。比较两组患者的减黄效果，并对不同病理类型的患者进行亚组分析。

结果

经过减黄治疗后，ERCP组术前总胆红素（TB）低于PTCD组[74.9（37.6

135.4）μmol·L

-1

92.7（48.6

143.2）μmol·L

-1

，

0.05

]

，减黄有效率高于PTCD组（78.0%

60.0%，

0.05）。胆总管下段癌患者中，ERCP组术前TB低于PTCD组[68.6（33.9

127.3）μmol·L

-1

82.3（35.4

132.5）μmol·L

-1

，

0.05

]

，减黄有效率高于PTCD组（80.9%

61.1%，

0.05）。

结论

恶性低位梗阻性黄疸患者，尤其是胆总管下段癌患者，术前采用ERCP进行减黄治疗的临床效果优于PTCD，在临床实践中值得推荐。

Abstract

Objective

To investigate the jaundice⁃reducing outcomes of different preoperative biliary drainage methods in the treatment of malignant low obstructive jaundice

and to summarize the clinical experience.

Methods

A retrospective cohort study was conducted to collect the clinical data of 76 patients with malignant low obstructive jaundice who underwent preoperative jaundice⁃reducing treatment and elective pancreaticoduodenectomy in a single center from January 2019 to December 2024. The patients were divided into two groups according to the method of preoperative biliary drainage: ERCP group (

=41) underwent endoscopic retrograde cholangiopancreatography biliary stent placement

and PTCD group (

=35) underwent percutaneous transhepatic biliary drainage. The clinical outcomes of reducing jaundice was compared between the two groups

and subgroup analysis was performed according t

o their pathological types.

Results

After treatment

the serum total bilirubin (TB) in ERCP group was lower than that in PTCD group (74.9（37.6

135.4） μmol·L

-1

92.7（48.6

143.2） μmol·L

-1

0.05)

and the effective rate of relieving jaundice in ERCP group was higher than that in PTCD group (78.0%

60.0%

0.05). In patients with distal common bile duct cancer

the preoperative TB in the ERCP group was lower than that in the PTCD group (68.6（33.9

127.3） μmol·L

-1

82.3（35.4

132.5） μmol·L

-1

0.05)

and the effective rate of biliary drainage in the ERCP group was higher than that in the PTCD group (80.9%

61.1%

0.05).

Conclusion

For patients with malignant low obstructive jaundice

especially for those with distal common bile duct cancer

ERCP has a better clinical effect than PTCD for preoperative biliary drainage

and it is worth recommending in clinical practice.

关键词

Keywords

references

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