Value of intra-biliary contrast-enhanced ultrasound in ultrasound-guided percutaneous transhepatic cholangial drainage

doi:10.3877/cma.j.issn.1672-6448.2023.03.013

Abstract

Abstract:

Objective

To evaluate the value of intra-biliary contrast-enhanced ultrasound (IB-CEUS) in percutaneous transhepatic cholangial drainage (PTCD).

Methods

A retrospective analysis was conducted on 210 patients with biliary obstruction who underwent ultrasound-guided PTCD at Ningbo Second Hospital from January 2020 to July 2021. The patients were divided into a control group (101 cases) and a contrast group (109 cases) based on whether IB-CEUS was performed. The differences in surgical success rate, incidence of complications, and efficacy in treating jaundice were compared between the two groups by the chi-square test.

Results

The success rate was 100% in both groups. The total incidence of postoperative complications in the contrast group was 8.3% (9/109), slightly higher than that of the control group (5.0%, 5/101), but there was no statistically significant difference between the two groups (P>0.05). In terms of efficacy, there were 3 cases (2.8%, 3/109) of ineffectiveness in reducing jaundice in the contrast group, and 15 cases (14.9%, 15/101) in the control group. The contrast group had significantly better efficacy in reducing jaundice than the control group (χ²=10.29, P=0.006).

Conclusion

The use of IB-CEUS during PTCD surgery can guide drainage strategies and achieve better efficacy in reducing jaundice.

Key words: Contrast-enhanced ultrasound, Biliary, Percutaneous transhepatic cholangial drainage, Biliary obstruction

Xiaoxiang Fan, Meiwu Zhang, Shuyi Lyu, Luhui Zhuang, Yan Zhang. Value of intra-biliary contrast-enhanced ultrasound in ultrasound-guided percutaneous transhepatic cholangial drainage[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(03): 332-336.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2023.03.013

https://chaosheng.cma-cmc.com.cn/EN/Y2023/V20/I03/332

Figures/Tables 4

变量	对照组（n=101）	造影组（n=109）	统计值	P值
性别［例（%）］			χ²=0.36	0.547
男	57（56.44）	57（52.29）
女	44（43.56）	52（47.71）
年龄（岁， $x ¯$ ±s）	67.72±11.82	67.28±10.72	t=0.28	0.778
术前总胆红素［μmol/L，M（Q_R）］	195.60（122.90，262.50）	177.70（124.10，238.40）	Z=0.89	0.371
术前直接胆红素［μmol/L，M（Q_R）］	170.70（105.70，221.70）	153.20（109.20，214.90）	Z=0.41	0.684
术前天冬氨酸转氨酶［U/L，M（Q_R）］	119.00（70.00，214.00）	124.00（71.00，213.00）	Z=-0.16	0.874
术前丙氨酸转氨酶［U/L，M（Q_R）］	105.00（58.00，203.00）	121.00（80.00，222.00）	Z=-1.63	0.103
Bismuth分型［例（%）］ Ⅰ型 Ⅱ型 Ⅲ型 Ⅳ型	42（41.6） 3（3.0） 46（45.5） 10（9.9）	44（40.4） 5（4.6） 49（45.0） 11（10.0）	χ²=-0.90	0.614

变量	对照组（n=101）	造影组（n=109）	统计值	P值
性别［例（%）］			χ²=0.36	0.547
男	57（56.44）	57（52.29）
女	44（43.56）	52（47.71）
年龄（岁， $x ¯$ ±s）	67.72±11.82	67.28±10.72	t=0.28	0.778
术前总胆红素［μmol/L，M（Q_R）］	195.60（122.90，262.50）	177.70（124.10，238.40）	Z=0.89	0.371
术前直接胆红素［μmol/L，M（Q_R）］	170.70（105.70，221.70）	153.20（109.20，214.90）	Z=0.41	0.684
术前天冬氨酸转氨酶［U/L，M（Q_R）］	119.00（70.00，214.00）	124.00（71.00，213.00）	Z=-0.16	0.874
术前丙氨酸转氨酶［U/L，M（Q_R）］	105.00（58.00，203.00）	121.00（80.00，222.00）	Z=-1.63	0.103
Bismuth分型［例（%）］ Ⅰ型 Ⅱ型 Ⅲ型 Ⅳ型	42（41.6） 3（3.0） 46（45.5） 10（9.9）	44（40.4） 5（4.6） 49（45.0） 11（10.0）	χ²=-0.90	0.614

组别	例数	退黄无效［例（%）］	退黄有效［例（%）］	术后总胆红素［μmol/L，M（Q_R）］	术后直接胆红素［μmol/L，M（Q_R）］
对照组	101	15（14.9）	86（85.1）	70.70（29.90，159.50）	61.90（24.20，143.10）
造影组	109	3（2.8）	106（97.2）	46.00（25.30，78.90）	40.10（20.00，71.60）
统计值		χ²=10.29		Z=2.53	Z=2.41
P值		0.006		0.011	0.016

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