Comparison of efficiency and prognostic analysis in four biliary drainages for treatment of malignant obstructive jaundice

Objectives: This study was to evaluate different biliary drainage for the treatment of malignant obstructive jaundice. Methods: 152 patients suffering from malignant obstructive jaundice were divided into 4 groups, including percutaneous transhepatic biliary drainage (PTBD), endoscopic plastic biliary stent (EPBS), endoscopic metal biliary stent (EMBS), and endoscopic metal biliary stent combined with plastic stent (EPBS+EMBS). Results: The successful drainage rates of PTBD group, EPBS group, EMBS group, and EPBS+EMBS group were 54.2%, 59.1%, 70.8%, and 80.6%. The complication rates of PTBD group, EPBS group, EMBS group, and EPBS+EMBS group were 62.5%, 27.2%, 31.3%, and 16.7%. The mean length of drainage patency of PTBD group, EPBS group, EMBS group, and EPBS+EMBS group was 46 days, 82 days, 142 days, and 164 days. The mean survival time of patients was 191 days in PTBD group, 266 days in EPBS group, 284 days in EMBS group, and 436 days in EPBS+EMBS group. Through Cox proportional hazards regression, the Child-pugh class, age, infection, and TNM stage contributed to a higher probability of death, while the drainage method and gender contributed to a lower probability of death. Conclusion: The EPBS+EMBS drainage method may improve the successful biliary drainage, have lower complications, longer patency, and longer survival time than other drainage methods.