Nursing care of patients with malignant obstructive jaundice treated by biliary stent implantation via ERCP

Objective To evaluate the clinical efficacy and to summarize the nursing experience of biliary stent placement via ERCP approach in the treatment of malignant obstructive jaundice. Methods The postoperative nursing experience of 101 patients with malignant obstructive jaundice treated with biliary stent placement via ERCP from January, 2010 to September, 2016 was summarized. In addition, we observed the changes of serum total bilirubin(TBIL), direct bilirubin (DBIL), alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and albumin (ALB) after the operation.Patients were followed up until September, 2017 or death. The survival time was recorded and the survival curve was drawn. Results In the study, all patients had a success operation. The symptoms such as itching were significantly improved after the operation. Compared with the preoperative levels, the levels of TBIL, DBIL, ALP, ALT, and AST significantly decreased 1 week and 1 month after the operation, and the differences were statistically significant (P<0.001). In addition, the level of albumin (ALB) significantly increased 1 week and 1 month after the operation, with statistical significance (P<0.001). The overall complication rate was 42.6% (43/101) and all of them cured after the symptomatic treatment and meticulous care. The average survival time was (8.96±1.02) months, and the median survival time was 9 months. Conclusion ERCP-based biliary stents are effective in the treatment of malignant obstructive jaundice. However, strict observation and careful nursing after operation are very important.