带药泵的硅胶管胆道旁路内引流治疗恶性胆道梗阻

目的　研究一种简单有效治疗晚期恶性胆道梗阻的胆道内引流方法。方法　 5 8例晚期恶性胆道梗阻患者 ,分为 2组 :( 1)带药泵旁路置管内引流组 (旁路内引流组 ) ,2 5例。置硅胶管于胆道梗阻上端及空肠内 ,行胆道旁路搭桥 ,并附加化疗药泵于硅胶管中 ,行定期冲洗胆道。 ( 2 )对照组 ,3 3例。仅行胆肠内引流。结果　两组有效退黄率差异无显著性 ,但随访期间旁路内引流组黄疸再出现率 ( 9.5 2 % )及胆道感染率 ( 2 0 .83 % )均明显低于对照组 (分别为 3 2 .14 %和 5 1.61% ,均P <0 .0 5 )。结论　带药泵的硅胶管胆道旁路搭桥内引流术方法简单 ,疗效满意 ,是一种较为有效的治疗恶性胆道梗阻的方法。

Biliojejunal bypass procedue by using silica gel tube combination with Bardport TM pump in treating the malignant biliary obstruction

Objective To study a simple and effective internal bilioenterostomy for the malignant bile duct obstruction.Methods 58 obstructive jaundice patients caused by advanced carcinoma were divided into 2 groups(1)Bridge bilioenterostomy(BBES) group.Biliojejunal bypass procedue by using silica gel tube inserted into dilated bile duct and jejunum respectively combination with Bardport TM pump was performed on 25 patients .The biliary sludge were washed away through Bardport TM pump by injecting normal saline, antibiotic and 5-fluorouracil.(2)Control group.33 patients were treated with traditional biliojejunostomy. Results There was no difference in alleviating jaundice between the two groups ,but in BBES group the cholangitis rate (20.83%)and recurrent jaundice rate (9.52%) were much lower than those in control group ( 51.61% and 32.14% respectively, P<0.05) in the follow-up period.Conclusions Biliojejunal bypass procedue by using silica gel tube combining with Bardport TM pump is a simple and effective biliary bypass for patients with malignant obstructive jaundice.