内镜胆道内支架引流治疗伴肝脏转移的胰头癌16例

目的:评价伴肝脏转移的胰头癌患者内镜胆道内支架引流治疗的临床意义.方法:门诊就诊和转院的胰头癌伴有肝脏转移患者,如具有严重的梗阻性黄疸则符合内镜逆行胆胰管造影救治指征,然后按照知情同意的原则进入治疗研究计划.均应用内镜胆道内支架引流技术,包括金属内支架和塑料支架.治疗出院后随访观察至患者死亡.结果:16例患者进入治疗研究,其中伴有腹膜后淋巴结转移5例.均采用内镜胆道支架引流术,其中应用胆道金属支架12例,胆道塑料支架4例,胰管内支架6例.治疗后1 wk时梗阻性黄疸缓解率100%,精神状况明显好转75.0%(12/16),食欲改善25.0%(4/16),睡眠改善37.5%(6/16).治疗后的患者最短生存期为9d,最长生存期为134 d,平均81.4 d±50.2 d.随访数据表明治疗有意义的97%,治疗效果满意的11例.结论:对于伴有肝脏转移的胰头癌患者,内镜胆道内支架引流技术不仅能解除梗阻性黄疸,而且可以一定程度的改善生存质量,具有一定的临床应用价值.

Endoscopic biliary drainage by stent placement for carcinoma of the head of the pancreas with hepatic metastasis:a report of 16 cases

AIM:To evaluate the clinical significance of endoscopic biliary drainage by stent placement in the treatment of carcinoma of the head of the pancreas with hepatic metastasis.METHODS:Sixteen patients with obstructive jaundice,who were diagnosed as carcinoma of the head of the pancreas with hepatic metastasis by imaging between May 2006 and December 2008,were included in the study.All patients underwent stent placement for endoscopic biliary drainage to cure obstructive jaundice.RESULTS:Retroperitoneal lymph ...