Interventional treatment of obstructive jaundice

  Clinically, obstructive jaundice due to benign and malignant lesions can seriously affect the patient’s quality of life because of pruritus, decreased appetite, and even liver failure.  Interventional drainage can quickly relieve the patient’s clinical symptoms, create conditions for elective surgery, and also serve as a long-term palliative treatment, and in some cases, further stenting can be performed to significantly improve the quality of life and prolong the patient’s life. Percutaneous transhepatic perforation of the bile duct with metal stent placement is an emerging interventional radiology technique at home and abroad in recent years. The average time of validity of the expanded metal stent is about 10 months, and the six-month opening rate of the endoprosthesis is about 60%, which is caused by biliary sludge, bleeding, tissue debris deposition and compression of the stent by tumor growth. The effect of metal endoprosthesis biliary drainage is comparable to that of surgical endoprosthesis, and should be the first choice of treatment.  Advantages: (1) Less painful and easy to accept; (2) Less invasive, safer and more suitable for a wide range of applications, especially in cases of advanced age, multiple entrapment and poor general condition (3) Greater advantage for high grade bile duct cancer, primary liver cancer and high grade obstructive xanthogranuloma caused by hilar lymph node or intrahepatic metastasis; (4) For cases where xanthogranuloma cannot be reduced by surgical exploration, internal stenting can still be used. (4) Internal stenting can still be used in cases where surgical exploration has failed to reduce the gangrene.  (5) Biliary stenting is a minimally invasive treatment that reduces the patient’s psychological burden, facilitates daily life and work, and shortens the hospital stay, thus improving the quality of survival.  Clinical application can be applied to postoperative bile duct stricture, bile duct anastomosis stricture, biliary ductitis, pancreatitis and other benign strictures caused by bile duct stenting, while temporary stenting is its development direction. Most occlusive jaundice that cannot be surgically resected is suitable for stenting as long as internal drainage can be performed.