Study of reasonable selecting interventional methods in treating high-positioned biliary tract obstruction

Objective: To investigate the interventional methods and clinical efficacy in high-positioned bile duct obstruction.Methods: From Jan.2005 to Jan.2008,45 patients with high-positioned bile duct obstruction were treated in our department.Thirteen patients were treated with combined percutaneous transhepatic cholangial drainage(PTCD) and stent implantation,17 with transcatheter arterial chemo-embolization(TACE) and/or infusion(TAI) followed by stent implantation,6 with PTCD,3 with stent implantation followed by radiofrequency ablation,3 with stent implantion followed by TACE,2 with radiofrequency ablation and 1 with TACE.Results: Thirty-nine patients obtained jaundice disappearance/palliation(total bilirubin 100umol/L) with the total effective rate of 87%;the survival time was 1 month to 17 month,mean 7.2 month;postoperative complications included cholangitis in 5 patients,postoperative hemobilia in 3 and postoperative bile peritonitis in 1,which were all recovered with conservative treatment.Conclusion: Selection of reasonable interventional methods for high-positioned bile duct obstruction can effectively palliate jaundice,improve life quality and extend patients'survival time.