[Long-term outcome of interventional therapy for malignant biliary obstruction: a retrospective analysis of 109 cases].

Objective To evaluate the long-term outcome and its relative influenced factors ofinterventional therapy in dealing malignant biliary obstruction (MBO). Method 109 MBO patients, 54males and 55 females, aged (71±12), underwent interventional therapy: 55 patients received percutaneoustranshepatic cholangiography and drainage (PTCD), and 54 underwent bile duct stent implantation. Oneweek later, total bilirubin (TB), direct bilirubin (DB), and alanine transaminase (ALT) were examined,and Child-Pugh scoring was conducted. 38 of the patient underwent transcatheter arterial chemo-embolization(TACE). Results One week after drainage the levels of ALT, TB, and DB of the patients undergoingPTCD and stent implantation all decreased in comparison with those before the treatment, the levels of thestent implantation group being significandy lower than those of the PTCD group ( P = 0. 019, 0.002, and0.002 respectively), but there was no significant difference in Child-Pugh scale between these 2 group (P =0.396). One week after TACE the levels of TB, DB, and Child-Pugh scale of the TACE group were allsignificantly lower than those of the patients without TACE ( P = 0.000, 0.002, and 0.002 respectively),however, there was no significant difference in ALT level between these 2 groups ( P = 0.834 ). Thecumulative mean survival time was 26.45 weeks [standard error (SE) 4.07], and the mean survival time ofthe PTCD group was 28.19 weeks( SE,6.54), not significantly different from that of the stenting groups were[21.38 weeks( SE,2.51 ) ,P = 0.713 ]. The mean survival time of the TACE group was 43.71 weeks ( SE,8.32), significantly longer than that of the patients without TACE [ 14.38 weeks ( SE,2.66) ,P =0.000].Conclusion Stenting is more effective than PTCD on relieving jaundice when the decreasing extent ofbilirubin level is concerned. TACE therapy following PTCD and stent implantation will significantly contributeto the survival time of MBO patients. Key words: Cholestasis;  Drainage;  Stents;  Radiology,interventional