American journal of translational research · 2026
Clinical efficacy of percutaneous transhepatic biliary drainage for obstructive jaundice in pancreatic cancer and risk factors for postoperative pancreatitis.
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Meng Yongbin, Li Ye, Yang Jue, Yao Wenyi, Zhang Yufei
Аннотация
OBJECTIVE: To investigate the clinical efficacy of percutaneous transhepatic biliary drainage (PTBD) for obstructive jaundice in pancreatic cancer and identify the independent risk factors for postoperative pancreatitis after PTBD.
METHODS: A retrospective cohort study included 145 consecutive patients with pancreatic cancer admitted to Shanghai Seventh People's Hospital from June 2022 to June 2024, assigned to either the endoscopic retrograde biliary drainage (ERBD, n=72) group or the PTBD (n=73) group. The PTBD group was further subdivided into pancreatitis (n=11) and non-pancreatitis (n=62) subgroups. Clinical data were compared between groups. Univariate and Firth multivariate logistic regression analyses identified independent factors, with ROC curves evaluating predictive value.
RESULTS: Baseline data were balanced between groups (all P>0.05). PTBD yielded more significant improvements in liver function and a shorter jaundice resolution time (all P<0.05), yet was associated with a significantly higher incidence of postoperative pancreatitis (P<0.05). High body mass index (BMI), Oddi sphincter dysfunction, and difficult intubation were independent risk factors (P<0.05), while external drainage was a protective factor (OR=0.064, P=0.023). A multivariate combined predictive model constructed from these factors exhibited excellent predictive efficacy (area under the curve (AUC) =0.960, 95% CI: 0.918-1.000).
CONCLUSION: PTBD effectively relieves obstructive jaundice and improves liver function. High-risk patients (elevated BMI, Oddi sphincter dysfunction, difficult intubation) require close monitoring, and prioritizing external drainage may reduce postoperative pancreatitis risk.
METHODS: A retrospective cohort study included 145 consecutive patients with pancreatic cancer admitted to Shanghai Seventh People's Hospital from June 2022 to June 2024, assigned to either the endoscopic retrograde biliary drainage (ERBD, n=72) group or the PTBD (n=73) group. The PTBD group was further subdivided into pancreatitis (n=11) and non-pancreatitis (n=62) subgroups. Clinical data were compared between groups. Univariate and Firth multivariate logistic regression analyses identified independent factors, with ROC curves evaluating predictive value.
RESULTS: Baseline data were balanced between groups (all P>0.05). PTBD yielded more significant improvements in liver function and a shorter jaundice resolution time (all P<0.05), yet was associated with a significantly higher incidence of postoperative pancreatitis (P<0.05). High body mass index (BMI), Oddi sphincter dysfunction, and difficult intubation were independent risk factors (P<0.05), while external drainage was a protective factor (OR=0.064, P=0.023). A multivariate combined predictive model constructed from these factors exhibited excellent predictive efficacy (area under the curve (AUC) =0.960, 95% CI: 0.918-1.000).
CONCLUSION: PTBD effectively relieves obstructive jaundice and improves liver function. High-risk patients (elevated BMI, Oddi sphincter dysfunction, difficult intubation) require close monitoring, and prioritizing external drainage may reduce postoperative pancreatitis risk.