经内镜放置胆管支架治疗恶性胆管梗阻

目的 探讨经内镜放置胆管支架治疗恶性胆管梗阻的效果.方法 176例失去手术机会的恶性胆管梗阻患者于经内镜逆行胰胆管造影下放置胆管支架,其中70例行胆管单塑料支架引流术(单支架组),2例行胆管双塑料支架引流术(双支架组),4例行胆管金属支架引流术(金属支架组),对比研究各组的引流效果及早期并发症的发生情况.结果 术后1周时,单支架组、双支架组和金属支架组的谷丙转氨酶、总胆红素、直接胆红素和碱性磷酸酶水平均较治疗前显著下降(P值均<0.05);双支架组和金属支架组的总胆红素和直接胆红素水平均显著低于单支架组(P值均<0.05),而双支架组与金属支架组间的差异无统计学意义(P值均>0.05).单支架组、双支架组和金属支架组的手术成功率分别为97.1%(68/70)、78.8%(41/52)和92.6%(50/54),单支架组的手术成功率显著高于双支架组(P<0.05),金属支架组与单支架组、双支架组的差异均无统计学意义(P值均>0.05).单支架组、双支架组和金属支架组早期并发症发生率分别为15.7%(11/70)、13.5%(7/52)和1.9%(1/54),单支架组、双支架组的早期并发症发生率显著高于金属支架组(P值均<0.05),单支架组与双支架组的差异无统计学意义(P>0.05).结论 经内镜逆行胰胆管造影下放置胆管支架对于恶性胆管梗阻有肯定的引流效果,双支架和金属支架的引流效果优于单支架.

Endoscopic placement of biliary stent in treatment of malignant biliary obstruction

Objective To evaluate the efficacy of endoscopic placement of biliary stent in treatment of malignant biliary obstruction.Methods A total of 176 patients with maligmant biliary obstruction,who had lost the chance for surgery,were treated with biliary stent through endoscopic retrograde cholangiopancreatography.Seventy patients received endoscopic retrograde biliary drainage with single stent,52 patients with double stents,and 54 patients with endoscopic metal biliary endoprothesis.The drainage outcomes and ...