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. 2024 Oct 12;24(1):307.
doi: 10.1186/s12893-024-02595-w.

Analysis of the efficacy of Percutaneous Transhepatic Cholangiography Drainage (PTCD) and Endoscopic Retrograde Cholangiopancreatography (ERCP) in the treatment of Malignant Obstructive Jaundice (MOJ) in palliative drainage and preoperative biliary drainage: a single-center retrospective study

Yiheng Cai #  1   2 , Zhuoyang Fan #  1   2 , Guowei Yang #  1   2 , Danyang Zhao  2 , Liting Shan  1   2 , Shenggan Lin  3 , Wei Zhang  4   5 , Rong Liu  6   7
Affiliations

Analysis of the efficacy of Percutaneous Transhepatic Cholangiography Drainage (PTCD) and Endoscopic Retrograde Cholangiopancreatography (ERCP) in the treatment of Malignant Obstructive Jaundice (MOJ) in palliative drainage and preoperative biliary drainage: a single-center retrospective study

Yiheng Cai et al. BMC Surg. .

Abstract

Purpose: This study aimed to assess the safety and efficacy of percutaneous transhepatic cholangiography drainage (PTCD) and endoscopic retrograde cholangiopancreatography (ERCP) in palliative drainage and preoperative biliary drainage for treating malignant obstructive jaundice (MOJ).

Methods: A total of 520 patients with MOJ who underwent PTCD or ERCP were enrolled and classified into palliative drainage group and preoperative biliary drainage group. Baseline characteristics, liver function, blood routine, complications were compared among the groups.

Results: The technical success rates for PTCD and ERCP in palliative group were 97.1% and 85.9%. In palliative drainage group, PTCD had higher levels of total bilirubin (TB) reduction (53.0 (30.0,97.0) vs. 36.8 (17.9,65.0), p < 0.001) and direct bilirubin (DB) reduction (42.0 (22.0,78.5) vs. 28.0 (12.0,50.8), p = 0.001) than ERCP. However, PTCD was associated with higher rates of drainage tube displacement (20 cases, 11.8%), while ERCP had a higher incidence of biliary infection (39 cases, 22.8%) and pancreatitis (7 cases, 4.1%). In preoperative drainage group, PTCD achieved a 50% reduction in total bilirubin faster than ERCP (7.1 days vs. 10.5 days). And the time from palliation of jaundice to surgery was 24.2 days in PTCD group and 35.7 days in ERCP group, a statistically significant difference (Student's t test, p = 0.017).

Conclusion: Both PTCD and ERCP could improve liver function for MOJ patients. PTCD seems to offer better outcomes in jaundice reduction and liver function improvement in palliative drainage, but requires careful postoperative management. In preoperative biliary drainage, PTCD may be a better preoperative bridge to improve liver function and control infection.

Keywords: Complication; ERCP; Efficacy; MOJ; PTCD.

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Conflict of interest statement

All authors declare that (i) no support, financial, or otherwise has been received from any organization that may have an interest in the submitted work and (ii) there are no other relationships or activities that could appear to have influenced the submitted work.

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart represents study selection process. MOJ malignant obstructive jaundice, PTCD percutaneous transhepatic cholangiography and drainage, ERCP endoscopic retrograde cholangiopancreatography
See this image and copyright information in PMC

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References

    1. Palmieri LJ, Lavolé J, Dermine S, Brezault C, Dhooge M, Barré A, et al. The choice for the optimal therapy in advanced biliary tract cancers: chemotherapy, targeted therapies or immunotherapy. Pharmacol Ther. 2020;210: 107517. 10.1016/j.pharmthera.2020.107517. - PubMed
    1. Forner A, Vidili G, Rengo M, Bujanda L, Ponz-Sarvisé M, Lamarca A. Clinical presentation, diagnosis and staging of cholangiocarcinoma. Liver Int: Off J Int Assoc Stud Liver. 2019;39(Suppl):198–107. 10.1111/liv.14086. - PubMed
    1. Lokich JJ, Kane RA, Harrison DA, McDermott WV. Biliary tract obstruction secondary to cancer: management guidelines and selected literature review. J Clin Oncol. 1987;5:969–81. 10.1200/jco.1987.5.6.969. - PubMed
    1. Chu D, Adler DG. Malignant biliary tract obstruction: evaluation and therapy. J Natl Compr Cancer Net. 2010;8:1033–44. 10.6004/jnccn.2010.0075. - PubMed
    1. Subbiah V, West HJ. Jaundice (Hyperbilirubinemia) in Cancer. JAMA Oncol. 2016;2:1103. 10.1001/jamaoncol.2016.1236. - PubMed

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