[Rate of biliary ducts' decompression by the tumorous obstructive jaundice]

Area of Science:

• Gastroenterology and Hepatology
• Surgical Oncology
• Interventional Radiology

Background:

• Malignant obstructive jaundice presents significant challenges in patient management.
• Biliary decompression is crucial for improving outcomes in these patients.
• Different decompression methods carry varying risks and benefits.

Purpose of the Study:

• To analyze the outcomes of different biliary decompression techniques in patients with malignant obstructive jaundice.
• To compare the efficacy and safety of nasobiliary drainage, percutaneous transhepatic bile drainage, and cholecystectomy.
• To evaluate the impact of decompression rate on patient outcomes and complications.

Main Methods:

• Retrospective analysis of 185 patients with malignant obstructive jaundice.
• Categorization of patients based on decompression method: nasobiliary drainage (n=85), percutaneous transhepatic bile drainage (n=37), and cholecystectomy (n=63).
• Evaluation of biochemical blood serum indices, cholangiomanometry, and jaundice response using a modified formula to estimate bile flow rate.

Main Results:

• Nasobiliary drainage resulted in low-rate decompression.
• Percutaneous transhepatic bile drainage and cholecystectomy led to high-rate decompression.
• Low-rate decompression significantly decreased the incidence of "fast decompression syndrome" and associated complications, including liver dysfunction, multiple organ failure, and mortality.

Conclusions:

• Low-rate biliary decompression, particularly via nasobiliary drainage, is associated with a lower frequency of severe complications post-decompression.
• High-rate decompression methods may increase the risk of adverse events such as liver dysfunction and multiple organ failure.
• Choosing the appropriate decompression strategy based on the rate is critical for optimizing patient outcomes in malignant obstructive jaundice.