Abstract: Objective To explore the impact of ultrasound-guided percutaneous transhepatic cholangiography drainage (PTCD) on severity scoring and liver function in patients with malignant obstructive jaundice (MOJ). Methods From February 2021 to November 2023, 76 MOJ patients were admitted to the Nuclear Industry 416 Hospital and randomly divided into two groups using the envelope drawing method: the ERCP group (n=38) and the PTCD group (n=38). The ERCP group received endoscopic retrograde cholangiopancreatography (ERCP) treatment, while the PTCD group underwent ultrasound-guided PTCD. Perioperative indicators, liver function, immune markers, severity scores, and complications were compared between the two groups before and after treatment. Results The surgery time (52.37±4.28 minutes), number of punctures (2.07±0.17 times), bile drainage volume (3.69±0.23 liters), effective catheterization time (12.52±1.09 days), and first ambulation time (3.15±0.26 days) of the PTCD group were all lower than those of the ERCP group (61.87±5.34 minutes, 4.26±0.33 times, 4.74±0.25 liters, 17.43±1.56 days, and 4.69±0.32 days, respectively) (P<0.05). After treatment, the levels of TBil (154.38±13.71 μmol/L), DBil (116.35±9.21 μmol/L), AST (87.44±6.82 IU/L), and GCT (89.44±7.67 IU/L) in the PTCD group were lower than those in the ERCP group (174.85±16.18 μmol/L, 134.82±11.03 μmol/L, 105.03±8.71 IU/L, and 112.03±10.32 IU/L, respectively) (P<0.05). The levels of IgA (2.63±0.26 g/L), IgM (10.56±1.05 g/L), IgG (12.33±1.20 g/L), CD4⁺ (39.22±4.07%), and CD4⁺/CD8⁺ (1.77±0.16) in the PTCD group were higher than those in the ERCP group (1.80±0.17 g/L, 7.97±0.80 g/L, 9.60±1.10 g/L, 35.41±3.70%, and 1.25±0.12, respectively), while CD8⁺ (22.33±2.46%) was lower than that in the ERCP group (26.41±2.77%) (P<0.05).The systemic inflammatory response syndrome (sSIRS) score (1.20±0.16), Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score (6.83±0.42), and Sequential Organ Failure Assessment (SOFA) score (2.64±0.15) in the PTCD group were all lower than those in the ERCP group (1.78±0.27, 8.15±0.61, and 3.35±0.25, respectively) (P<0.05). There was no statistically significant difference in the complication rates between the ERCP and PTCD groups (13.2% vs. 10.5%) (P>0.05). Conclusion Ultrasound-guided PTCD has a positive effect on severity scoring and liver function in patients with MOJ.

Key words: Ultrasound, Percutaneous transhepatic cholangiography drainage, Severity scoring, Liver function