title: Comparison of infection between internal-external and external percutaneous transhepatic biliary drainage in treating patients with malignant obstructive jaundice.
abstract: OBJECTIVE
  Percutaneous transhepatic biliary drainage (PTBD) is a form of palliative care for patients with malignant obstructive jaundice. We here compared the infection incidence between internal-external and external drainage for patients with malignant obstructive jaundice.
  
  
  METHODS
  Patients with malignant obstructive jaundice without infection before surgery receiving internal-external or external drainage from January 2008 to July 2014 were recruited. According to percutaneous transhepatic cholangiography (PTC), if the guide wire could pass through the occlusion and enter the duodenum, we recommended internal-external drainage, and external drainage biliary drainage was set up if the occlusion was not crossed. All patients with infection after procedure received a cultivation of blood and a bile bacteriological test.
  
  
  RESULTS
  Among 110 patients with malignant obstructive jaundice, 22 (52.4%) were diagnosed with infection after the procedure in the internal-external drainage group, whereas 19 (27.9%) patients were so affected in the external drainage group, the difference being significant (p<0.05). In 8 patients (36.3%) in the internal-external group infection was controlled, as compared to 12 (63.1%) in the external group (p<0.05). The mortality rate for patients with infection not controlled in internal-external group in one month was 42.8%, while this rate in external group was 28.6% (p<0.05).
  
  
  CONCLUSIONS
  External drainage is a good choice, which could significantly reduce the chance of biliary infection caused by bacteria, and decrease the mortality rate at one month and improve the long-term prognosis.
authors.affiliation: Department of Interventional Radiology, Subei People's Hospital of Jiangsu Province, Clinical Hospital of Yangzhou University, Yangzhou, China E-mail : huangxinen06@163.com, 13004307189@qq.com.
authors.forename: Chuan
authors.initials: C
authors.lastname: Xu
authors.forename: Xin-En
authors.initials: XE
authors.lastname: Huang
authors.forename: Shu-Xiang
authors.initials: SX
authors.lastname: Wang
authors.forename: Peng-Hua
authors.initials: PH
authors.lastname: Lv
authors.forename: Ling
authors.initials: L
authors.lastname: Sun
authors.forename: Fu-An
authors.initials: FA
authors.lastname: Wang
mesh_terms: D055499:Catheter-Related Infections / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D002404:Catheterization / Q000009:adverse effects*; D004322:Drainage / Q000009:adverse effects* / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D041781:Jaundice, Obstructive / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate