经皮肝穿刺胆道金属内支架植入后再狭窄的评价

目的探讨经皮肝穿刺胆道金属内支架植入后再狭窄的形成原因及处理方法。方法经皮肝穿刺胆道金属内支架植入术后再狭窄患者75例,其中30例接受经皮经肝胆道造影并经该途径取得支架狭窄处组织的病理学诊断。同时再次应用经皮肝穿刺胆道金属内支架植入或外引流解决胆道再狭窄。结果获得病理学诊断结果的30例患者中,15例为因肿瘤生长引起支架狭窄,10例为慢性炎症,5例为胆砂形成。另45例为早期病例,无钳取病理条件,未接受病理组织学活检。经治疗后明显好转50例,改善21例,治疗无效4例,有效率为94.67%。结论经皮肝穿刺胆道引流术及胆道金属内支架植入术为治疗支架再狭窄的有效、安全的方法。肿瘤生长为引起经皮肝穿刺胆道金属内支架植入术后再狭窄的主要原因。

Evaluation of the biliary metal stent restenosis after percutaneoustranshepatic biliary metal stent implantation

Objective To discuss the causes and the treatment of restenosis after percutaneous transhepatic biliary metal stent implantation.Methods There were 75 patients of restenosis after percutaneous transhepatic biliary metal stent implantation.Percutaneous transhepatic cholangiography was performed,and pathological diagnosis of the tissue at the restenosis lesions was obtained in 30 of them.At the same time percutaneous transhepatic biliary metal stent implantation or extra-drainage were taken to deal with the b...