To explore the application value of percutaneous transhepatic cholangiodrainage (PTCD) combined with bile transfusion in the preoperative preparation for patients with malignant obstructive jaundice.

Clinical data of 124 patients with malignant obstructive jaundice underwent radical surgery in Gansu Provincial Hospital between May 2006 and June 2015 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. The patients were divided into the biliary drainage group (n=76) and control group (n=48) according to the preoperative treatments. In the biliary drainage group, 50 males and 26 females, aged (54±3) years old on average, underwent PTCD combined with bile transfusion on the basis of routine preoperative preparation. In the control group, 31 males and 17 females, aged (56±3) years old on average, received routine preoperative preparation alone. Preoperative and postoperative liver function, biliary tract inflammation indexes, intraoperative and postoperative situation in two groups were compared using t test. And the rate was compared using Chi-square test.

Compared with the indexes on admission, the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), total bilirubin (TB) and C-reactive protein in the biliary drainage group at 1 d before operation significantly declined (t=-14.19, -18.47, -31.99, -22.86, -24.69, -20.47; P<0.05). Compared with those in the control group, the levels of ALT, AST, TB and PT in the biliary drainage group at postoperative 7 d significantly declined (t=-8.59, -17.79, -21.76, -8.75; P<0.05), whereas the level of ALB significantly increased (t=10.41, P<0.05). The operation time of cholecystojejunostomy and pancreaticoduodenectomy in the biliary drainage group was respectively (98±14) and (204±21) min, significantly shorter than (116±14) and (248±25) min in the control group (t=-6.97, -10.55; P<0.05). The intraoperative blood loss of cholecystojejunostomy and pancreaticoduodenectomy in the biliary drainage group was respectively (115±11) and (224±24) ml, significantly lower than (151±16) and (312±30) ml in the control group (t=-14.85, -18.03; P<0.05). The postoperative length of hospital stay in the biliary drainage group was (13±3) d, significantly shorter than (19±3) d in the control group (t=-10.85, P<0.05).

For patients with malignant obstructive jaundice, preoperative PTCD combined with bile transfusion help to enhance the patients' tolerance to the radical surgery, reduce the intraoperative blood loss, shorten operation time and accelerate postoperative recovery of liver function, thereby improving the effect of operation.