比较经皮经肝穿刺胆道引流术（PTBD）不同引流方式治疗肝门区恶性梗阻性黄疸的近期疗效。

回顾性分析154例肝门区恶性梗阻性黄疸患者的临床资料，根据接受的不同PTBD引流方式分为壶腹上内外引流、跨壶腹内外引流、外引流及双侧PTBD引流四组，同时将外引流组分为横跨引流组及单纯外引流组两个亚组，利用单因素方差分析或卡方检验比较近期疗效的差异。

肝门区梗阻性黄疸不同引流方式在缓解TBIL、DBIL、TBA、ALT、AST、ALP、rGGT及术后肾功能损害发生率方面彼此之间没有差异。跨壶腹内外引流术后胆道感染发生率明显高于其他引流方式。

不同PTBD引流方式对肝门区恶性梗阻性黄疸在减黄和缓解肝功能方面效果相当。

To compare the therapeutic effect of different approach of percutaneous transhepatic cholangial drainage (PTBD) in the therapy of perihilar obstructive jaundice caused by malignance.

We retrospectively analyzed the data of 154 patients who underwent PTBD for Perihilar malignant obstructive jaundice (MOJ) from Jan 2011 to Dec 2012 in Beijing chaoyang hospital. According to the approach of PTBD, we divide the cases into four groups: internal-external drainage across the ampulla, inter-external drainage above the ampulla, external drainage and bilateral PTBD. The group of external drainage was further divided into two subgroup: simple external drainage and bridge bilateral external drainage. The diversity of curative effect among the different groups was compared and analyzed.

There is no difference among the palliation of the TBIL, DBIL, TBA, AST, ALT, ALP, rGGT and the impairment of renal function after the procedures for different approach of PTBD. Nevertheless, the group of the internal-external drainage Across the Ampullae has a greater incidence rate of biliary infection after PTBD compared with the other groups and the difference was statistically significant.

There is no difference between the five different approach of PTBD in alleviating jaundice and liver dysfunction.