The correlative factors of palliation efficacy in malignant obstructive jaundice_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

GU Yuelei ,  YANG Sunhu , FAN Qiang , ZHANG Longlong

Department of General Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201999, P. R. China;

Corresponding author：

YANG Sunhu, Email: yangsh06@126.com

Keywords：

malignant obstructive jaundice; palliation efficacy; influencing factor

DOI：

10.7507/1007-9424.201803043

Video：

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Objective To explore the influencing factors of palliation efficacy in malignant obstructive jaundice. Methods Clinical data of 107 patients with malignant obstructive jaundice who treated in Department of General Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, from March 2014 to December 2017, were retrospectively collected to analyze the influencing factors of palliation efficacy in 1 week and1 month after operation. Results Multivariate analysis results showed that, hilar obstruction and preoperative albumin level were influencing factors of palliation efficacy in 1 week after operation (P<0.05), patients with hepatic portal obstruction, and low preoperative albumin level had poor effect; hilar obstruction, preoperative albumin and total bilirubin level were influencing factors of palliation efficacy in 1 month after operation (P<0.05), patients with hepatic portal obstruction, low preoperative albumin level, and high total bilirubin level had poor effect. Conclusions The obstruction location, preoperative albumin level, and total bilirubin level are the independent influencing factors of palliation efficacy which played an important role in prognostic assessment.

Citation： GU Yuelei, YANG Sunhu, FAN Qiang, ZHANG Longlong. The correlative factors of palliation efficacy in malignant obstructive jaundice. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(9): 1087-1093. doi: 10.7507/1007-9424.201803043 Copy

1.	徐川, 施海彬, 刘圣, 等. 肝门部胆管癌致梗阻性黄疸介入引流治疗的预后分析. 介入放射学杂志, 2012, 21(9): 752-755.
2.	徐晨, 夏金堂, 徐波, 等. 恶性梗阻性黄疸术前减黄利弊的系统评价. 中华普通外科学文献: 电子版, 2011, 5(1): 68-74.
3.	欧盛秋, 马亦龙. 恶性梗阻性黄疸的治疗现状与进展. 中外医疗, 2014, 33(18): 197-198.
4.	Park S, Park JY, Chung MJ, et al. The efficacy of endoscopic palliation of obstructive jaundice in hepatocellular carcinoma. Yonsei Med J, 2014, 55(5): 1267-1272.
5.	Cho HC, Lee JK, Lee KH, et al. Are endoscopic or percutaneous biliary drainage effective for obstructive jaundice caused by hepatocellular carcinoma? Eur J Gastroenterol Hepatol, 2011, 23(3): 224-231.
6.	Lee JW, Han JK, Kim TK, et al. Obstructive jaundice in hepatocellular carcinoma: response after percutaneous transhepatic biliary drainage and prognostic factors. Cardiovasc Intervent Radiol, 2002, 25(3): 176-179.
7.	Günther RW, Schild H, Thelen M. Percutaneous transhepatic biliary drainage: experience with 311 procedures. Cardiovasc Intervent Radiol, 1988, 11(2): 65-71.
8.	Akiyama H, Okazaki T, Takashima I, et al. Percutaneous treatments for biliary diseases. Radiology, 1990, 176(1): 25-30.
9.	宋勇, 秦高平, 杜立学, 等. 胆道支架联合PTCD对恶性梗阻性黄疸患者肝功能与生活质量的影响研究. 肝胆外科杂志, 2017, 25(2): 118-122.
10.	李臻, 李娅, 李腾飞, 等. 金属胆道支架治疗恶性梗阻性黄疸的临床疗效. 中华肝脏病杂志, 2012, 20(11): 843-847.
11.	Suh YG, Kim DY, Han KH, et al. Effective biliary drainage and proper treatment improve outcomes of hepatocellular carcinoma with obstructive jaundice. Gut Liver, 2014, 8(5): 526-535.
12.	胡冰, 周岱云, 龚彪, 等. 可膨式金属胆道支架解除恶性胆管梗阻的临床应用及其疗效分析. 中华外科杂志, 1999, 37(5): 25-28.
13.	Carrasco CH, Zornoza J, Bechtel WJ. Malignant biliary obstruction: complications of percutaneous biliary drainage. Radiology, 1984, 152(2): 343-346.
14.	Baron TH. Palliation of malignant obstructive jaundice. Gastroenterol Clin North Am, 2006, 35(1): 101-112.
15.	Becker CD, Glättli A, Maibach R, et al. Percutaneous palliation of malignant obstructive jaundice with the Wallstent endoprosthesis: follow-up and reintervention in patients with hiar and nonhilar obstruction. J Vasc Interv Radiol, 1993, 4(5): 597-604.
16.	Martin JA, Slivka A, Rabinovitz M, et al. ERCP and stent therapy for progressive jaundice in hepatocellular carcinoma: which patients benefit, which patients don’t? Dig Dis Sci, 1999, 44(7): 1298-1302.
17.	Matsueda K, Yamamoto H, Umeoka F, et al. Effectiveness of endoscopic biliary drainage for unresectable hepatocellular carcinoma associated with obstructive jaundice. J Gastroenterol, 2001, 36(3): 173-180.
18.	于平, 钱晓军, 马展鸿, 等. 恶性梗阻性黄疸合并胆系感染的临床分析. 当代医学: 中国介入放射学, 2008, 2(2): 155-157.
19.	Kordzaya DJ, Goderdzishvili VT. Bacterial translocation in obstructive jaundice in rats: role of mucosal lacteals. Eur J Surg, 2000, 166(5): 367-374.
20.	Tomioka M, Iinuma H, Okinaga K. Impaired Kupffer cell function and effect of immunotherapy in obstructive jaundice. J Surg Res, 2000, 92(2): 276-282.
21.	Hernández Guerrero A, Sánchez del Monte J, Sobrino Cossío S, et al. Prognostic factors of mortality in the malignant biliary obstruction unresectable after the insertion of an endoscopic stent. Rev Gastroenterol Mex, 2006, 71(1): 22-30.
22.	陈文超, 柳国胜. 单纯光疗或光疗联合白蛋白治疗足月新生儿重度黄疸的效果分析. 中国病理生理杂志, 2015, 31(5): 943-946.
23.	Hosono S, Ohno T, Kimoto H, et al. Effects of albumin infusion therapy on total and unbound bilirubin values in term infants with intensive phototherapy. Pediatr Int, 2001, 43(1): 8-11.
24.	李维勤, 黎介寿, 全竹富, 等. 严重感染病人低白蛋白血症的影响因素与临床意义. 肠外与肠内营养, 2000, 7(4): 252.
25.	Vincent JL, Dubois MJ, Navickis RJ, et al. Hypoalbuminemia in acute illness: is there a rationale for intervention? A meta-analysis of cohort studies and controlled trials. Ann Surg, 2003, 237(3): 319-334.
26.	Jo JH, Park BH. Suprapapillary versus transpapillary stent placement for malignant biliary obstruction: which is better? J Vasc Interv Radiol, 2015, 26(4): 573-582.
27.	Huang X, Shen L, Jin Y, et al. Comparison of uncovered stent placement across versus above the main duodenal papilla for malignant biliary obstruction. J Vasc Interv Radiol, 2015, 26(3): 432-437.
28.	Lee SJ, Kim MD, Lee MS, et al. Comparison of the efficacy of covered versus uncovered metallic stents in treating inoperable malignant common bile duct obstruction: a randomized trial. J Vasc Interv Radiol, 2014, 25(12): 1912-1920.
29.	朱晓丹, 陈卫刚, 韩岩智, 等. 恶性梗阻性黄疸不同姑息治疗方法疗效观察. 中国内镜杂志, 2015, 21(4): 371-374.
30.	梁运啸, 黄鹏宇, 农兵. 肝外胆管梗阻的支架治疗研究进展. 世界华人消化杂志, 2017, 25(13): 1173-1178.
31.	翟仁友, 黄强. 恶性梗阻性黄疸介入治疗常见问题的处理. 介入放射学杂志, 2007, 16(10): 649-651.
32.	黄可, 关文华, 韩焱, 等. 恶性梗阻性黄疸介入治疗术后并发胆道感染的相关因素分析. 河南科技大学学报: 医学版, 2014, 32(3): 177-179.
33.	王刚, 黎冶, 刘万泉. 恶性梗阻性黄疸支架植入术后的近期并发症分析. 中国医药指南, 2017, 15(1): 79-80.

1. 徐川, 施海彬, 刘圣, 等. 肝门部胆管癌致梗阻性黄疸介入引流治疗的预后分析. 介入放射学杂志, 2012, 21(9): 752-755.
2. 徐晨, 夏金堂, 徐波, 等. 恶性梗阻性黄疸术前减黄利弊的系统评价. 中华普通外科学文献: 电子版, 2011, 5(1): 68-74.
3. 欧盛秋, 马亦龙. 恶性梗阻性黄疸的治疗现状与进展. 中外医疗, 2014, 33(18): 197-198.
4. Park S, Park JY, Chung MJ, et al. The efficacy of endoscopic palliation of obstructive jaundice in hepatocellular carcinoma. Yonsei Med J, 2014, 55(5): 1267-1272.
5. Cho HC, Lee JK, Lee KH, et al. Are endoscopic or percutaneous biliary drainage effective for obstructive jaundice caused by hepatocellular carcinoma? Eur J Gastroenterol Hepatol, 2011, 23(3): 224-231.
6. Lee JW, Han JK, Kim TK, et al. Obstructive jaundice in hepatocellular carcinoma: response after percutaneous transhepatic biliary drainage and prognostic factors. Cardiovasc Intervent Radiol, 2002, 25(3): 176-179.
7. Günther RW, Schild H, Thelen M. Percutaneous transhepatic biliary drainage: experience with 311 procedures. Cardiovasc Intervent Radiol, 1988, 11(2): 65-71.
8. Akiyama H, Okazaki T, Takashima I, et al. Percutaneous treatments for biliary diseases. Radiology, 1990, 176(1): 25-30.
9. 宋勇, 秦高平, 杜立学, 等. 胆道支架联合PTCD对恶性梗阻性黄疸患者肝功能与生活质量的影响研究. 肝胆外科杂志, 2017, 25(2): 118-122.
10. 李臻, 李娅, 李腾飞, 等. 金属胆道支架治疗恶性梗阻性黄疸的临床疗效. 中华肝脏病杂志, 2012, 20(11): 843-847.
11. Suh YG, Kim DY, Han KH, et al. Effective biliary drainage and proper treatment improve outcomes of hepatocellular carcinoma with obstructive jaundice. Gut Liver, 2014, 8(5): 526-535.
12. 胡冰, 周岱云, 龚彪, 等. 可膨式金属胆道支架解除恶性胆管梗阻的临床应用及其疗效分析. 中华外科杂志, 1999, 37(5): 25-28.
13. Carrasco CH, Zornoza J, Bechtel WJ. Malignant biliary obstruction: complications of percutaneous biliary drainage. Radiology, 1984, 152(2): 343-346.
14. Baron TH. Palliation of malignant obstructive jaundice. Gastroenterol Clin North Am, 2006, 35(1): 101-112.
15. Becker CD, Glättli A, Maibach R, et al. Percutaneous palliation of malignant obstructive jaundice with the Wallstent endoprosthesis: follow-up and reintervention in patients with hiar and nonhilar obstruction. J Vasc Interv Radiol, 1993, 4(5): 597-604.
16. Martin JA, Slivka A, Rabinovitz M, et al. ERCP and stent therapy for progressive jaundice in hepatocellular carcinoma: which patients benefit, which patients don’t? Dig Dis Sci, 1999, 44(7): 1298-1302.
17. Matsueda K, Yamamoto H, Umeoka F, et al. Effectiveness of endoscopic biliary drainage for unresectable hepatocellular carcinoma associated with obstructive jaundice. J Gastroenterol, 2001, 36(3): 173-180.
18. 于平, 钱晓军, 马展鸿, 等. 恶性梗阻性黄疸合并胆系感染的临床分析. 当代医学: 中国介入放射学, 2008, 2(2): 155-157.
19. Kordzaya DJ, Goderdzishvili VT. Bacterial translocation in obstructive jaundice in rats: role of mucosal lacteals. Eur J Surg, 2000, 166(5): 367-374.
20. Tomioka M, Iinuma H, Okinaga K. Impaired Kupffer cell function and effect of immunotherapy in obstructive jaundice. J Surg Res, 2000, 92(2): 276-282.
21. Hernández Guerrero A, Sánchez del Monte J, Sobrino Cossío S, et al. Prognostic factors of mortality in the malignant biliary obstruction unresectable after the insertion of an endoscopic stent. Rev Gastroenterol Mex, 2006, 71(1): 22-30.
22. 陈文超, 柳国胜. 单纯光疗或光疗联合白蛋白治疗足月新生儿重度黄疸的效果分析. 中国病理生理杂志, 2015, 31(5): 943-946.
23. Hosono S, Ohno T, Kimoto H, et al. Effects of albumin infusion therapy on total and unbound bilirubin values in term infants with intensive phototherapy. Pediatr Int, 2001, 43(1): 8-11.
24. 李维勤, 黎介寿, 全竹富, 等. 严重感染病人低白蛋白血症的影响因素与临床意义. 肠外与肠内营养, 2000, 7(4): 252.
25. Vincent JL, Dubois MJ, Navickis RJ, et al. Hypoalbuminemia in acute illness: is there a rationale for intervention? A meta-analysis of cohort studies and controlled trials. Ann Surg, 2003, 237(3): 319-334.
26. Jo JH, Park BH. Suprapapillary versus transpapillary stent placement for malignant biliary obstruction: which is better? J Vasc Interv Radiol, 2015, 26(4): 573-582.
27. Huang X, Shen L, Jin Y, et al. Comparison of uncovered stent placement across versus above the main duodenal papilla for malignant biliary obstruction. J Vasc Interv Radiol, 2015, 26(3): 432-437.
28. Lee SJ, Kim MD, Lee MS, et al. Comparison of the efficacy of covered versus uncovered metallic stents in treating inoperable malignant common bile duct obstruction: a randomized trial. J Vasc Interv Radiol, 2014, 25(12): 1912-1920.
29. 朱晓丹, 陈卫刚, 韩岩智, 等. 恶性梗阻性黄疸不同姑息治疗方法疗效观察. 中国内镜杂志, 2015, 21(4): 371-374.
30. 梁运啸, 黄鹏宇, 农兵. 肝外胆管梗阻的支架治疗研究进展. 世界华人消化杂志, 2017, 25(13): 1173-1178.
31. 翟仁友, 黄强. 恶性梗阻性黄疸介入治疗常见问题的处理. 介入放射学杂志, 2007, 16(10): 649-651.
32. 黄可, 关文华, 韩焱, 等. 恶性梗阻性黄疸介入治疗术后并发胆道感染的相关因素分析. 河南科技大学学报: 医学版, 2014, 32(3): 177-179.
33. 王刚, 黎冶, 刘万泉. 恶性梗阻性黄疸支架植入术后的近期并发症分析. 中国医药指南, 2017, 15(1): 79-80.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The correlative factors of palliation efficacy in malignant obstructive jaundice

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