Relationship between ways of nutritional support and immune function in patients with malignant obstructive jaundice after PTCD

Objective To investigate the clinical effect of different nutritional therapies on the immune function of patients with malignant obstructive jaundice after percutaneous transhepatic cholangiodrainage (PTCD) . Methods A total of 50 patients with malignant obstructive jaundice who were admitted to our hospital from January 2009 to March 2013 were randomly divided into two groups according to the admission order. The patients in group A (n = 25) received enteral nutritional support after PTCD, and those in group B (n = 25) received total parenteral nutritional support after PTCD. Intra- group and inter- group comparisons were made in terms of jaundice clearance, nutritional indices, and body's immune function on preoperative day 1 and postoperative day 7; comparison between the two groups was made by t test.Results Among the 50 patients who underwent PTCD, 39 (78%) had good drainage, while 11 (22%) did not reach the expectation, of which, 5 (10%) were in group A and 6 (12%) in group B. In both groups, the nutritional indices on postoperative day 7 were significantly higher than those on preoperative day 1 (P < 0. 05) , but no significant difference in these indices was observed between group A and group B on postoperative day 7 (P > 0. 05) . The immune function of patients in both groups was significantly improved following PTCD and nutritional support (P < 0. 05) , but there was no significant difference between the two groups (P > 0. 05) . Although the same scheme of nutritional support was used, there were 11 patients who did not achieve the expected jaundice clearance after PTCD and had limited improvement in immune function compared with those who had complete jaundice clearance (all P < 0. 05) . Conclusion Jaundice clearance is closely related to PTCD in patients with malignant obstructive jaundice, but not markedly associated with the ways of nutritional support.