Utility of enteral nutrition via percutaneous transhepatic cholangiography drainage catheterization in late-stage malignant obstructive jaundice

Abstract

Objective: The purpose of this study was to explore the clinical benefits of establishing an enteral nutrition (EN) pathway via percutaneous transhepatic cholangiography drainage (PTCD) catheterization in patients with late-stage malignant obstructive jaundice (MOJ).Methods: We selected 30 patients diagnosed as having late-stage MOJ with malnutrition. A dual-lumen biliary-enteral nutrition tube was placed via PTCD along with a biliary stent implantation. Postoperative EN was provided, and we observed the time taken for tube placement, its success rate, complications, and therapeutic efficacy.Results: Tube placement was successful in all 30 patients with an average procedural time of 5.7 ± 1.4 min with no tube placement complications. Compared to preoperative measures, there was a significant improvement in postoperative jaundice reduction and nutritional indicators one month after the procedure (p < 0.05). Post-placement complications included tube perileakage in 5 cases, entero-biliary reflux in 4 cases, tube blockage in 6 cases, tube displacement in 4 cases, accidental tube removal in 3 cases, and tube replacement due to degradation in 8 cases, with tube retention time ranging from 42 to 314 days, averaging 124.7 ± 37.5 days. All patients achieved the parameters for effective home-based enteral nutrition with a noticeable improvement in their quality of life.Conclusion: In this study, we found that the technique of establishing an EN pathway via PTCD catheterization was minimally invasive, safe, and effective; the tube was easy to maintain; and patient compliance was high. It is, thus, suitable for long-term tube retention in patients with late-stage MOJ.

Keywords:

• Enteral nutrition
• malignant obstructive jaundice
• nutrition pathway
• percutaneous transhepatic cholangiography drainage

Acknowledgements

We would like to acknowledge the hard and dedicated work of all the staff that implemented the intervention and evaluation components of the study.

Ethics approval and consent to participate

This study was conducted with approval from the Ethics Committee of The First People’s Hospital of Yinchuan (No. 2020021). This study was conducted in accordance with the declaration of Helsinki. Written informed consent was obtained from all participants.

Consent for publication

All participants signed a document of informed consent.

Authors’ contributions

Conception and design of the research: Jian-Hua Cao

Acquisition of data: Jian-Jun Yao, Hai-Min Li, Gao-Xiang Li, Jie Chen, Sheng Wang, Xue-Wen Yang

Analysis and interpretation of the data: Jian-Jun Yao, Hai-min Li, Gao-Xiang Li, Jie Chen, Sheng Wang, Xue-Wen Yang

Statistical analysis: Zhan-Hu Mu, Gao-Xiang Li

Obtaining financing: Jian-Hua Cao

Writing of the manuscript: Jian-Hua Cao, Zhan-Hu Mu, Gao-Xiang Li

Critical revision of the manuscript for intellectual content: Jian-Hua Cao, Gao-Xiang Li

All authors read and approved the final draft.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets used and/or analyzed during the current study available from the corresponding author on reasonable request.

Additional information

Funding

This study was funded by the Key Research and Development Projects of Ningxia Hui Autonomous Region of China (No. 2021BEG03080). The funding body had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.