胆道内支架置入结合动脉化疗栓塞术治疗恶性胆道梗阻

目的探讨经皮肝穿刺胆道内支架置入术结合动脉化疗栓塞治疗恶性胆道梗阻的临床疗效。方法12例恶性胆道梗阻病人采用经皮肝穿刺胆道内支架置入术，2周后行供血动脉灌注化疗和/或化疗栓塞，每月一次。结果12例病人共放置国产网状支架14枚。11例病人血清胆红素水平由术前534±120μmol/L降至术后的45±23μmol/L。半年以上生存率83.3%，一年以上生存率50%，2例病人4个月后因胆管再次梗阻第二次置放支架。12例病人共行动脉化疗栓塞35次，显示了明确疗效。结论经皮肝穿刺胆道内支架置入术结合动脉化疗栓塞是治疗恶性胆道梗阻安全、有效的方法。

Percutaneous Transhepatic Insertion of Metalic Stent and Arterial Chemoemblization for Malignent Biliary Obstruction

Objective:To vealuate the effect of percutaneous transhepaticinsertion of biliary setents(PTIBS) and arterial chemoenbolization for treatment of malignent biliary obstruction(MBO).Methods:Twelve patients with MBO were treated with PTIBS,following by arterial chemoenbolization in two weeks,one time each months.Results:Fourteen stents were placed in 12 cases.The total serum bilirubin level declined from 534±120 umol/L to 45±23 umol/L in 11 patients.The survival rate of 6 and 12 monthes were 83.3% and 50% respectively.Two cases were reobsturcted after 5 months of first stent implacemnt and were retreated by insertion of second stents.The total thirty-five times arterial chemoembolization was performed in 12 cases with remarkable effect.Conclusion:PTIBS combined arterial chemoembolization was an safe ;effective interventional treatment for MBO.