PTBD for the treatment of malignant obstructive jaundice associated with gastric cancer:an analysis of middle-term and long-term efficacy

Objective To evaluate the efficacy of percutaneous transhepatic biliary drainage(PTBD)in treating obstructive jaundice due to malignant biliary obstruction caused by gastric cancer,and to discuss its complications and predictive factors influencing survival quality.Methods Twenty-eight patients with malignant biliary obstruction caused by gastric cancer were enrolled in this study.All patients underwent PTBD.The clinical data were retrospectively analyzed.Follow-up check was conducted through out-patient clinic examination or telephone interview.Results After PTBD,the serum bilirubin levels decreased significantly,the liver function was remarkably improved and the clinical symptoms were obviously relieved in 25 patients.The main complications related to the intervention included cholangitis,pancreatitis,hemobilia and dislocation of drainage catheter.The mean survival time was 123 days.The survival rate at 3,6 an 12 months after PTBD was 57.14%,25% and 13.2% respectively.Univariate analysis showed that the main factors affecting the prognosis were the presence of liver metastasis and the degree of differentiation of the tumor cell.Conclusion PTBD is a safe and effective palliative measure for patients of gastric cancer accompanied with malignant biliary obstruction.PTBD can markedly improve patient's living quality and prolong the life span.