关键词: 肝门部胆管癌, 梗阻性黄疸, 内镜逆行胰胆管造影术, 经皮肝穿刺胆道引流术, 治疗

Abstract: Objective This study aimed to retrospectively compare clinical efficacy of endoscopic retrograde cholangiopancreatography (ERCP) vs. percutaneous transhepatic cholangial drainage (PTCD in dealing with patients with hilar cholangiocarcinoma (HiCC) and obstructive jaundice. Methods 56 patients with unresectable HiCC with hyperbilirubinemia were encountered in our hospital between January 2022 and December 2024, of them, ERCP was conducted in 30 cases and PTCD in 26 cases. Serum C-reactive protein (CRP) and interleukin-6 (IL-6) levels were detected by ELISA, and peripheral blood lymphocyte subsets were determined by FCM. Short-term quality of life was assessed by KPS score. Results By end of 7 days after operation, drainage tube patency in ERCP group was 93.3%,much higher than 76.9%(P<0.05), total serum bilirubin level was (79.3±23.5)μmol/L, much lower than [(98.6±26.7)μmol/L,P<0.05],while serum albumin level was (37.8±5.9)g/L, much higher than [(34.3±6.1)g/L,P<0.05] in PTCD group; incidence of post-operational complications was 20.0%,much lower than 46.2%(P<0.05) in PTCD group; by end of 14 days after surgery, serum CRP and IL-6 levels were both significantly lower than, while peripheral blood CD4⁺ cell percentage and CD4⁺/CD8⁺ cell ratio were both significantly higher than in PTCD group(P<0.05);KPS score and improvement of appetite were much higher than in PTCD group(P<0.05);median overall survival and 12 m survival rate were 9.8(8.4,11.3)mon and 43.3%,both much longer or higher than [7.2(6.1,8.4)mon and 26.9%,P<0.05] in PTCD group. Conclusion Both ERCP and PTCD could effectively relieve malignant obstructive jaundice in patients with HiCC, but we recommend ERCP preferentially as it seems more efficacious.

Key words: Hilar cholangiocarcinoma, Obstructive jaundice, Endoscopic retrograde cholangiopancreatography, Percutaneous transhepatic cholangial drainage, Therapy