Yang YB, Yan ZY, Jiao Y, Yang WH, Cui Q, Chen SP. Different percutaneous transhepatic biliary stent placements and catheter drainage in the treatment of middle and low malignant biliary obstruction. World J Gastrointest Surg 2023; 15(7): 1397-1404 [PMID: 37555122 DOI: 10.4240/wjgs.v15.i7.1397]
Corresponding Author of This Article
Si-Pan Chen, Doctor, Professor, Department of Interventional Radiology, Shaanxi Provincial People’s Hospital, No. 256 Youyi West Road, Beilin District, Xi’an 710068, Shaanxi Province, China. panda_spph@163.com
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Yao-Bo Yang, Zhao-Yong Yan, Yang Jiao, Wei-Hao Yang, Qi Cui, Si-Pan Chen, Department of Interventional Radiology, Shaanxi Provincial People’s Hospital, Xi’an 710068, Shaanxi Province, China
Author contributions: Chen SP initiated the project and designed the experiment; Yang YB conducted clinical data collection; Yan ZY, Yang WH, and Cui Q performed postoperative follow-up and recorded data; Jiao Y conducted data collation and statistical analysis; Yang YB wrote the original manuscript; Chen SP revised the paper; all authors reviewed and approved the final manuscript.
Institutional review board statement: The Ethics Committee of Shaanxi Provincial People’s Hospital approved the study.
Informed consent statement: Due to the retrospective nature of this study, the requirement for informed consent of patients was waived.
Conflict-of-interest statement: The author(s) declare having no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data sharing statement: All data generated or analyzed during this study are included in this published article.
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: Si-Pan Chen, Doctor, Professor, Department of Interventional Radiology, Shaanxi Provincial People’s Hospital, No. 256 Youyi West Road, Beilin District, Xi’an 710068, Shaanxi Province, China. panda_spph@163.com
Received: March 13, 2023 Peer-review started: March 13, 2023 First decision: March 28, 2023 Revised: April 21, 2023 Accepted: May 6, 2023 Article in press: May 6, 2023 Published online: July 27, 2023
ARTICLE HIGHLIGHTS
Research background
For cases of middle and low biliary obstruction with left and right hepatic duct dilatation, the type of approach and whether different approaches affect the difficulty of puncture operation and intraoperative and postoperative complications have not been discussed in detail.
Research motivation
This study compared the clinical efficacy of two different puncture paths in treating middle and low biliary obstruction. The study prioritized the optimal puncture pathway.
Research objectives
This study compared the efficacy of different pathways to find the best improvement in patient quality of life and survival rate.
Research methods
A retrospective analysis was performed on the medical records of 424 patients with middle and low biliary obstruction who underwent percutaneous liver puncture biliary stent placement and catheter drainage between March 2016 and March 2022. Based on the puncture path, patients were categorized into two groups: subxiphoid left hepatic lobe approach group (Group A) and right intercostal, right hepatic lobe approach group (Group B). Liver function improvement, postoperative biliary bleeding incidence, postoperative pain duration, and abdominal effusion leakage around the drainage tube were compared between the two groups at 3 d and 1 wk after the operation.
Research results
The decreased rates for total bilirubin, direct bilirubin, and alkaline phosphatase 1 wk after surgery were significantly faster in Group A than in Group B. The decreased rate of gamma-glutamyl transpeptidase was also significantly faster in Group A at both 3 d and 1 wk after surgery. Group A experienced significantly less peritoneal effusion leakage around the drainage tube than Group B. The patient survival rate was higher in Group A compared to Group B.
Research conclusions
The study proposed a humanistic care perspective, improving patient survival treatment in the later stage and prioritized the optimal puncture pathway.
Research perspectives
This research was carried out retrospectively and reflected the experiences of a single institution. More studies should be performed in the future.
