Comparison of wire-guided percutaneous transhepatic biliary drainage and conventional puncture in the treatment of acute obstructive suppurative cholangitis

Abstract

Abstract: Objective To compare the application effects of wire-guided percutaneous transhepatic biliary drainage (PTBD) and conventional puncture in the treatment of acute obstructive suppurative cholangitis (AOSC). Methods A total of 92 patients with AOSC who received treatment in our hospital from January 2019 to January 2024 were enrolled as the study subjects. They were randomly assigned to a control group (n=46) and an observation group (n=46). The control group underwent conventional PTBD, while the observation group underwent wire-guided PTBD. Perioperative indicators were recorded, and preoperative and postoperative (24 h) inflammatory cytokine levels and stress indices were compared between the two groups. Liver function was assessed 1 week postoperatively. Postoperative complications such as biliary tract hemorrhage, bile leakage, acute severe cholangitis, and sepsis were recorded. Results The operative time was (75.31 ± 13.37) min in the observation group and (73.42 ± 11.42) min in the control group, with one-time placement success rates of 100% and 93.48%, and daily drainage volumes of (287.26 ± 35.61) mL and (283.14 ± 31.35) mL, respectively. The differences were not statistically significant (P>0.05). At 24 hours postoperatively, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-8 (IL-8) in the observation group were (71.23 ± 7.63)pg/mL, (354.23 ± 39.36)pg/mL, and (649.05 ± 67.63) pg/mL, respectively, which were lower than those in the control group (P<0.05). No significant differences were observed in liver function indicators between the two groups at 1 week postoperatively (P>0.05). Postoperative complications in the control group included 5 cases of biliary hemorrhage, 2 cases of bile leakage, 7 cases of acute severe cholangitis, and 6 cases of sepsis, while the observation group had 4 cases of biliary hemorrhage, 2 cases of acute severe cholangitis, and 1 case of sepsis, with no bile leakage. Conclusion Wire-guided PTBD is more effective than conventional puncture in reducing postoperative inflammatory responses and stress levels in patients with AOSC, with a lower complication rate. However, there is no significant difference in their impact on liver function.

Key words: Wire-guided, Percutaneous transhepatic biliary drainage, Acute obstructive suppurative cholangitis, Liver function

WU Xian-chen, CHEN Chuang, LI Jia-zhou, LI Xiao-qing. Comparison of wire-guided percutaneous transhepatic biliary drainage and conventional puncture in the treatment of acute obstructive suppurative cholangitis[J]. Chinese Hepatolgy, 2026, 31(1): 123-126.

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