Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jun 27, 2024; 16(6): 1592-1600
Published online Jun 27, 2024. doi: 10.4240/wjgs.v16.i6.1592
Endoscopic ultrasound-guided biliary drainage vs percutaneous transhepatic bile duct drainage in the management of malignant obstructive jaundice
Qin-Qin Zhu, Bing-Fang Chen, Yue Yang, Xue-Yong Zuo, Wen-Hui Liu, Ting-Ting Wang, Yin Zhang
Qin-Qin Zhu, Bing-Fang Chen, Xue-Yong Zuo, Wen-Hui Liu, Ting-Ting Wang, Yin Zhang, Department of Gastroenterology, The Third Affiliated Hospital of Soochow University (The First People’s Hospital of Changzhou), Changzhou 213000, Jiangsu Province, China
Yue Yang, Department of Hepatobiliary and Pancreatic Surgery, The Third Affiliated Hospital of Soochow University (The First People’s Hospital of Changzhou), Changzhou 213000, Jiangsu Province, China
Author contributions: Zhu QQ conceptualized and conducted the research, authored the manuscript, and performed data analysis; Chen BF and Yang Y conducted literature review and provided research guidance; Zuo XY and Liu WH were responsible for data collection; Wang TT contributed to formal analysis and data visualization; Zhang Y offered research advice and oversaw the report preparation.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of The Third Affiliated Hospital of Soochow University (The First People’s Hospital of Changzhou).
Informed consent statement: An exemption from informed consent was requested and obtained from the Ethics Committee.
Conflict-of-interest statement: The authors declare no conflicts of interest in relation to this article.
Data sharing statement: The clinical data used in this study are available from the corresponding author upon request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yin Zhang, MD, Associate Chief Physician, Department of Gastroenterology, The Third Affiliated Hospital of Soochow University (The First People’s Hospital of Changzhou), No. 185 Juqian Street, Tianning District, Changzhou 213000, Jiangsu Province, China. czzhangyin@163.com
Received: January 25, 2024
Revised: February 21, 2024
Accepted: April 30, 2024
Published online: June 27, 2024
Processing time: 156 Days and 23.5 Hours
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.

AIM

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).

CONCLUSION

EUS-BD may reduce the number of punctures, improve liver and myocardial functions, alleviate traumatic stress, and decrease complication rates in MOJ treatment.

Keywords: Percutaneous hepatic biliary drainage, Endoscopic ultrasound-guided biliary drainage, Malignant obstructive jaundice, Clinical effect, Liver function, Postoperative complications

Core Tip: Malignant obstructive jaundice (MOJ) primarily manifests in advanced tumors, posing significant risks to patient survival and necessitating prompt treatment. The principal treatment methods for MOJ are endoscopic ultrasound-guided biliary drainage and percutaneous transhepatic bile duct drainage. However, the efficacy of these two procedures varies, and their clinical value and postoperative effects require further analysis. This study, involving 68 patients, compares the therapeutic outcomes of these two surgical treatments for MOJ, aiming to identify the optimal treatment strategy.