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1.
经内镜放置自膨式不带膜金属支架治疗胆管中下段恶性狭窄的疗效观察 总被引:2,自引:0,他引:2
目的 观察经内镜放置不带膜自膨式金属支架治疗胆管中下段恶性狭窄的效果。方法 对我院收治的晚期恶性肿瘤伴阻塞性黄疸且无法切除的 16例患者采用内镜置入不带膜自膨式金属支架治疗的结果进行回顾性分析。结果 15例 (94 % )成功置入不带膜自膨式金属支架 ,内引流通畅 ,置入不带膜自膨式金属支架后 7d及14d复查肝功能和B超 ,总胆红素、直接胆红素、转氨酶均较治疗前明显降低 (P<0 .0 1) ,胆总管直径明显变细 (P<0 .0 1)。其中 6例 3周内恢复正常。早期并发症 (置入不带膜金属支架后 7d内 ) :1例出现轻度急性胰腺炎 ,1例出现急性胆管炎 ,经抗感染及对症治疗后好转。平均存活时间为 186 .93d(5 4~ 4 2 6d) ,平均支架引流有效期为15 6d(5 1~ 4 2 6d) ,有 3例 (2 0 % )发生支架堵塞。结论 经内镜放置不带膜自膨式金属支架是治疗胆管中下段恶性狭窄的较理想方法。 相似文献
2.
John T. Mullen M.D. Jeffrey H. Lee M.D. Henry F. Gomez M.D. William A. Ross M.D. Norio Fukami M.D. Robert A. Wolff M.D. Eddie K. Abdalla M.D. Jean-Nicolas Vauthey M.D. Jeffrey E. Lee M.D. Peter W. T. Pisters M.D. Douglas B. Evans M.D. 《Journal of gastrointestinal surgery》2005,9(8):1094-1105
Contemporary treatment programs for patients with potentially resectable pancreatic cancer often involve preoperative therapy.
When the duration of preoperative therapy exceeds 2 months, the risk of plastic endobiliary stent occlusion increases. Metal
stents have much better patency but may complicate subsequent pancreaticoduodenectomy (PD). We evaluated rates of perioperative
morbidity, mortality, and stent complications in 272 consecutive patients who underwent PD at our institution from May 2001
to November 2004. Of these 272 patients, 29 (11%) underwent PD after placement of a metal stent, 141 underwent PD after placement
of a plastic stent, 10 had PD after biliary bypass without stenting, and 92 had PD without any form of biliary decompression.
No differences were found between the Metal Stent group and all other patients in median operative time, intraoperative blood
loss, or length of hospital stay. No perioperative deaths occurred in the Metal Stent group versus 3 (1.2%) deaths in the
other 243 patients. The incidence of major perioperative complications was similar between the two groups, including the rates
of pancreatic fistula, intra-abdominal abscess, and wound infection. Furthermore, there were no differences in the perioperative
morbidity or mortality rates between patients who underwent preoperative biliary decompression with a stent of any kind (metal
or plastic) and those patients who underwent no biliary decompression at all. Metal stent-related complications occurred in
2 (7%) of 29 patients during a median preoperative interval of 4.1 months; in contrast, 75 (45%) of the 166 patients who had
had plastic stents experienced complications, including 98 stent occlusions, during a median preoperative interval of 3.9
months (P < 0.001). We conclude that the use of expandable metal stents does not increase PD-associated perioperative morbidity
or mortality, and as such an expandable metal stent is our preferred method of biliary decompression in patients with symptomatic
malignant distal bile duct obstruction in whom surgery is not anticipated, or in whom there is a significant delay in the
time to surgery.
Presented at the Forty-Sixth Annual Meeting of The Society for Surgery of the Alimentary Tract, Chicago, Illinois, May 14–18,
2005 (oral presentation).
Supported by the Lockton Fund for Pancreatic Cancer Research, The University of Texas M. D. Anderson Cancer Center, Houston,
Texas. 相似文献
3.
Hiroyuki Isayama Takao Kawabe Yousuke Nakai Yukiko Ito Osamu Togawa Hirofumi Kogure Yoko Yashima Hiroshi Yagioka Saburo Matsubara Takashi Sasaki Naoki Sasahira Kenji Hirano Takeshi Tsujino Minoru Tada Masao Omata 《Surgical endoscopy》2010,24(1):131-137
Background
The covered metallic stent is effective for managing malignant distal biliary obstructions. The most popular covered metallic stent is the covered Wallstent (CWS). This study estimated the efficacy and safety of a new expanded polytetrafluoroethylene (e-PTFE)-covered nitinol metallic stent, the ComVi stent. This covered metallic stent consists of an e-PTFE membrane sandwiched between two uncovered metallic stents with weak axial (straightening) force. Wire is exposed on both the inner and outer surfaces.Methods
Between May 2005 and April 2007, ComVi stents were placed consecutively in 47 patients with unresectable malignant distal biliary obstruction. The cases involved 35 pancreatic cancers, 8 metastatic nodes, 2 gallbladder cancers, and 2 bile duct cancers. The patients were compared with 47 patients who received CWS placement between August 2001 and May 2005 matched for age, sex, and causative disease from 133 cases.Results
No significant differences in stent patency or patient survival were found. Stent occlusion was observed in 13 patients (27.7%) in the ComVi group and 10 patients (21.3%) in the CWS group. The cause of occlusion in both groups was tumor overgrowth (4.25% vs 4.2%), sludge (8.5% vs 6.3%), impaction of food scraps (14.9% vs 2.1%), and bile duct kinking (0% vs 8.4%). Other complications were migration (2.1% vs 17.0%; p = 0.0304) and cholecystitis (2.1% vs 6.3%), and there were significant differences in the incidence of complications except for occlusion (4.2% vs 24.6%; p = 0.0142).Conclusion
The ComVi stent has a patency similar to that of the CWS and a lower incidence of migration. However, early occlusion by food impaction was increased and should be resolved. 相似文献4.
U. Seitz M. K. Goenka S. Bohnacker K. F. Binmoeller N. Soehendra 《Journal of Hepato-Biliary-Pancreatic Surgery》1997,4(1):24-30
Since its introduction 1979, endoscopic biliary stenting has become the method of first choice to treat cholestasis in malignant or benign biliary obstuction or leakage of biliary fistulas. The success rate of endoscopic biliary stenting generally exceeds 90% and procedure-related complications are rare. Although metal stents are becoming more popular, plastic stents are still the first choice. Their major drawback is occlusion with sludge mediated by bacteria. Pharmaco-chemical measures failed to prevent occlusion. With Teflon material and a 10-French stent, stent exchange rates were reduced to 15% in patients with malignant biliary obstruction, the shape without sideholes showing the best results. Stent exchange is easily feasable. Metal stents are expensive and more difficult to handle. Occlusion with sludge is rare, but patency is limited by tumor ingrowth. Metal stents may be indicated in selected patients, such as those with recurrent stent occlusion causing cholangitis. If only a small-caliber prosthesis (7-Fr) can be placed (e.g. in Klatskin tumor) metal stents may have a longer patency than plastic stents. Metal stents should not be used in benign biliary obstruction because these stents are not removable. 相似文献
5.
目的对比内镜双金属支架和塑料支架引流治疗晚期肝门部胆管恶性梗阻的安全性和疗效。方法回顾性分析2007年1月至2013年10月收治的41例采用内镜支架引流治疗的晚期肝门部胆管恶性梗阻的临床资料。结果双金属支架相对于单塑料及双支架有更长的支架通畅时间(187±10 d vs 139±8.8 d;P0.05)。两组之间的术后并发症比较无明显统计学差异。双金属支架可以明显增加肝脏的容积。结论采用内镜双金属支架引流治疗晚期肝门部胆管恶性梗阻是安全可行的,同时可以明显改善肝脏的功能。 相似文献
6.
《Urological Science》2015,26(1):65-68
ObjectiveThis study was conducted to investigate the efficacy and safety of ureteral dilation and placement of a long-term ureteral stent for patients with various types of ureteral obstructions.MethodsWe retrospectively reviewed the records of 39 patients presenting with ureteral obstruction secondary to malignant strictures (n = 9) or nonmalignant strictures (n = 30). The mean age of these patients was 55.8 ± 16.1 years (range, 13–87 years). All patients underwent retrograde ureteral balloon dilation and placement of one to three ureteral stents. Stent patency rate and complications including febrile urinary tract infection, stent encrustation, and stent fragmentation were recorded.ResultsA total of 117 ureteral stents were implanted during the 83 procedures. Three stents were placed in seven patients and two stents in 20 patients. The patency rate was 95.2% with a mean 75-day follow-up. There was no encrustation in 104 stents and Grade 1 in 13 stents. The patency rate was similar between the patients with malignant strictures and those with nonmalignant strictures (100% vs. 94.7%, p = 0.57). However, three episodes of febrile urinary tract infection were noted only in patients with malignant strictures. The improvement of hydronephrosis and complications were also comparable between those patients with ureteral stents indwelling for >90 days and those for <90 days. No stent fragmentation was found in any of the patients.ConclusionWe demonstrated that ureteral dilation and placement of a single or multiple ureteral stents was effective and safe for patients with ureteral obstruction. 相似文献
7.
目的观察各胆道支架选择方式对不同病因恶性胆总管梗阻的疗效、术后并发症及治疗费用。方法选择2010年7月至2015年12月在我院肝胆外科因恶性胆总管梗阻行ERCP术置入胆道支架治疗的47例患者作为研究对象,按照置入胆道支架的不同,所有病例分为金属支架组(A组,n=16)、单塑料支架组(B组,n=17)和多塑料支架组(C组,n=14),观察三组患者支架通畅时间、并发症及手术相关费用。结果对于胰腺癌型,A组和C组的平均支架通畅时间明显比B组长(P0.05),且A组优于C组,但差异无统计学意义(P0.05);对于胆管癌型和壶腹周围癌型,A组和C组的平均支架通畅时间明显比B组长,差异有统计学意义(P0.05);其中C组优于A组,但差异无统计学意义(P0.05)。结论针对不同病因的恶性胆总管梗阻患者,选择个性化胆道支架治疗方案,既提高治疗效果,减少并发症,又降低医疗费用,为患者的后续治疗节省成本。 相似文献
8.
Everson L. A. Artifon Airton Z. Rodrigues Sergio Marques Bhawna Halwan Paulo Sakai Claudio Bresciani Atul Kumar 《Journal of gastrointestinal surgery》2007,11(12):1686-1691
Background Exploratory laparoscopy is commonly undertaken in patients with highly suspicious biliary and pancreatic lesions to facilitate
diagnosis and staging cancer is present. If an unresectable tumor is identified, a second endoscopic procedure may be required
do deploy a self-expandable metal stent (SEMS) for palliation. As endoscopic retrograde cholangio pancreatography (ERCP) may
be unsuccessful in up to 20% of patients, we evaluated the feasibility and safety of deployment of self-expandable metal stents
at the same time as the initial laparoscopy.
Patients and Methods A total of 23 eligible patients (8 male and 15 female) with malignant obstruction of the common bile duct underwent deployment
of SEMS at laparoscopy. Primary outcome measure was the successful laparoscopic deployment of stent and secondary outcome
measure was complications rates.
Results Indications for stent deployment were unresectable pancreatic cancer in 18, cholangiocarcinoma in two, neuroendocrine tumor
in one and ampullary adenocarcinoma in two patients. The median age was 73 years (range 49–93). Twenty-two of 23 stents were
deployed successfully: 17 stents were deployed transcystically and five via a choledochotomy. Median times for laparoscopic
exploration and SEMS deployment were 165 min (range 105–230) and 20 min (range 10–50), respectively. Pre- and post-procedures
median total bilirubin were 9.4 mg/dl (range 5.4–17.5) and 4.0 (range 2.6–7.1). The median size of the pancreatic mass was
3 cm (range 2–5 cm) and that of the common bile duct (CBD) from 9.2 mm (range 7.2–17.4). The mean duration of laparoscopy
was 170 min (range 120–230 min) and that for stent deployment 23 min (range 10–50 min). Complications included bleeding, obstruction,
and wound infection. Bleeding occurred on day 7 in two patients and on day 30 in one patient; bleeding occurred at the gastrojejunal
anastomosis site and was successfully treated with endoscopic hemostasis. A total of three stent obstructions were identified:
one each at 60, 90, and 120 days follow-up. All complications were successfully managed endoscopically. There were a total
of seven deaths, six as a result of progressive cancer and one of surgical wound infection and ensuing complications.
Conclusion This study demonstrates that laparoscopic deployment of self-expandable metal bile duct stents is feasible and safe. This
option appears to be a reasonable option in patients with inoperable malignant obstruction of the distal common bile duct. 相似文献
9.
Sammy E Elsamra David A Leavitt Hector A Motato Justin I Friedlander Michael Siev Mohamed Keheila David M Hoenig Arthur D Smith Zeph Okeke 《International journal of urology》2015,22(7):629-636
Extrinsic malignant compression of the ureter is not uncommon, often refractory to decompression with conventional polymeric ureteral stents, and frequently associated with limited survival. Alternative options for decompression include tandem ureteral stents, metallic stents and metal‐mesh stents, though the preferred method remains controversial. We reviewed and updated our outcomes with tandem ureteral stents for malignant ureteral obstruction, and carried out a PubMed search using the terms “malignant ureteral obstruction,” “tandem ureteral stents,” “ipsilateral ureteral stents,” “metal ureteral stent,” “resonance stent,” “silhouette stent” and “metal mesh stent.” A comprehensive review of the literature and summary of outcomes is provided. The majority of studies encountered were retrospective with small sample sizes. The evidence is most robust for metal stents, whereas only limited data exists for tandem or metal‐mesh stents. Metal and metal‐mesh stents are considerably more expensive than tandem stenting, but the potential for less frequent stent exchanges makes them possibly cost‐effective over time. Urinary tract infections have been associated with all stent types. A wide range of failure rates has been published for all types of stents, limiting direct comparison. Metal and metal‐mesh stents show a high incidence of stent colic, migration and encrustation, whereas tandem stents appear to produce symptoms equivalent to single stents. Comparison is difficult given the limited evidence and heterogeneity of patients with malignant ureteral obstruction. It is clear that prospective, randomized studies are necessary to effectively scrutinize conventional, tandem, metallic ureteral and metal‐mesh stents for their use in malignant ureteral obstruction. 相似文献
10.
目的 探讨通过内镜置入自膨式胆道金属支架治疗肝门部胆管癌的疗效.方法 回顾性分析2004年7月至2009年7月成都军区总医院收治的73例肝门部胆管癌患者行内镜胆道金属支架置入术的操作成功率、减黄有效率、支架通畅时间和生存时间以及术后并发症.结果 支架置入成功70例,3例失败.其中单金属支架置入62例,双侧金属支架置入3例,金属支架+塑料支架置人5例.减黄有效率为87%(61/70),中位支架通畅时间为190 d,中位生存时间为246 d.术后发生胆管炎7例,胰腺炎3例,出血2例.结论 内镜置入自膨式胆道金属支架治疗肝门部胆管癌创伤小、减黄效果好,可作为无法手术切除的肝门部胆管癌患者解除胆道恶性梗阻的首选治疗方法. 相似文献
11.
内镜逆行胰胆管造影术和支架置入术已逐渐成为远端恶性胆道梗阻患者的标准姑息治疗方式.但是随着各类材质支架的置入,废弃了Oddi括约肌的功能,改变了胆道正常解剖结构,致使十二指肠内容物易反流入胆管,患者发生胆管炎的概率明显升高,严重影响生活质量.为了减少胆管反流等相关不良事件的出现,抗反流支架应运而生.其大部分是通过在支架... 相似文献
12.
Yasuhiko Miura Itaru Endo Shinji Togo Hitoshi Sekido Koichiro Misuta Yoshiro Fujii Toru Kubota Kuniya Tanaka Kaoru Nagahori Hiroshi Shimada 《Journal of Hepato-Biliary-Pancreatic Surgery》2001,8(2):113-117
The aim of this study was to analyze the patency of expandable metallic stents in malignant biliary obstruction and to evaluate
the efficacy of adjuvant therapy accompanied by biliary stenting. We analyzed 29 patients in whom bile duct stenting was performed
for malignant biliary obstruction. Their types of disease were: hilar ductal carcinoma (n = 8), gallbladder carcinoma (n = 11), and pancreatic carcinoma (n = 10). Initially, 46 expandable metallic stents were placed in 29 patients. In 23 of the 29 patients, adjuvant therapy was
administered. Seventeen patients underwent radiotherapy, and 16 patients received various systemic chemotherapies. In principle,
hyperthermia was performed twice a week, simultaneously with radiotherapy. Patient survival and the probability of stent patency
were calculated using actuarial life table analysis. There was no significant difference in stent patency among the patients
according to type of disease. Hyperthermia did not influence the stent patency rate. The median stent patency time was significantly
greater in the chemo-radiation group than in the no-adjuvant therapy group: 182 days versus 68 days, respectively (P = 0.017). Moreover, a significant increase was seen in the median survival time in the chemo-radiation group: 261 days versus
109 days (P = 0.0337). Complications occurred in 9 patients (31.0%). Stent occlusion occurred in 6 patients (20.7%), with all of these
patients managed successfully using a transhepatically placed new expandable metallic stent, employing the stent-in-stent
method. Stent migration occurred in 2 patients after radiotherapy. Adjuvant therapies such as radiotherapy and systemic chemotherapy,
in combination with stent insertion, resulted in an increase in the patency period of expandable metallic stents and in increased
patient survival time.
Received: August 18, 2000 / Accepted: December 1, 2000 相似文献
13.
Girolamo Geraci Carmelo Sciumè Franco Pisello Francesco Li Volsi Tiziana Facella Giuseppe Modica 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2007,392(1):61-65
Objective The chemical composition and clinical significance of white bile in patients with malignant obstructive jaundice were evaluated
in a prospective study.
Materials and methods 115 consecutive patients with inoperable malignant biliary obstruction underwent endoscopic placement of 10 Fr straight, plastic
biliary stents, Amsterdam-type. Bile was aspirated during the endoscopic procedure and a blood sample was taken. Patients
were divided into two groups: those with white bile and those with yellow bile. The groups were compared for decremental fall
in bilirubin, cholangitis after stent insertion, and survival.
Results Thirty-five patients (15 men, 20 women; mean age 54 years) underwent endoscopic drainage for malignant obstruction (29 hilar,
6 distal bile duct). Eighteen patients had white bile. Refractory jaundice (p > −0.025) was seen in nine (50%) patients with white bile compared with three (17.6%) patients with yellow bile; mean difference
−42.2 (95% CI [−62.4, −22.0]) and −45.7 (95% CI [−72.0, −19.4]), respectively. The bilirubin (0.49 mg/L) and bile acid (14.6 mmol/L)
concentrations in white bile were significantly less than bilirubin (41.9 mg/L) and bile acid (62.2 mmol/L) concentrations
in yellow/black bile. Cholangitis developed in 66.6% of patients with white bile compared with 35% of those with yellow/black
bile (OR 3.67: 95% CI [0.74, 19.25]). Kaplan–Meier curves showed that median survival was shorter in patients with white bile
(36 [23–60] vs 75 [35–220] days) (p = 0.004, log rank test), which was significant even after adjusting for potential confounders with Cox proportional hazards
regression.
Conclusion White bile is largely devoid of bilirubin and bile acids. The presence of white bile was associated with significantly worse
survival in patients with malignant biliary obstruction. 相似文献
14.
胆道支架植入加介入化疗方法治疗高位恶性胆道梗阻的体会 总被引:2,自引:0,他引:2
目的:评估胆道支架植入结合介入化疗在高位恶性胆道梗阻病人中的疗效。方法:对49例植入胆道支架并辅以选择性动脉插管化疗的病人,回顾性分析血清总胆红素(SB)和碱性磷酸酶(AKP)的变化,及支架阻塞发生率和存活时间。结果:术后2周,血清总胆红素和碱性磷酸酶水平较术前明显下降。在39例植入(33.3%)可膨式金属支架病人中,13例(33.3%)发生阻塞,中位阻塞时间为10个月;10例塑料支架均在术后4个月内出现阻塞。本组病人的中位生存时间为12个月,1年生存率为55%,2年生存率为20%。结论:对高位恶性胆道梗阻病人,植入胆道支架同时辅以选择性动脉化疗是合适的治疗方法。可膨式金属支架较塑料支架的效果更好。 相似文献
15.
Nonsurgical treatment aims at controlling disease and improving survival and quality of life in patients with nonresectable, recurrent metastatic cholangiocarcinomas. After R0 resection, percutaneous or intraluminal radiotherapy with adjuvant radiochemotherapy may improve survival. Available data, however, are still unsatisfactory, and the efficacy of adjuvant radiochemotherapy after R0 resection remains to be confirmed. Exclusive chemotherapy fails to improve survival postoperatively while, in adequate patients, neoadjuvant chemotherapy can improve R0 resection results. Palliative chemotherapy yielded improved survival and quality of life in only one small prospective randomized trial and cannot be generally recommended at present. Previous biliary stenting for relieving jaundice is mandatory. Beyond established regimens employing 5-fluorouracil/leukovorin and gemcitabine plus platin-based agents, ongoing trials are focussing on topoisomerase-and thyrosine kinase inhibitors. Palliative stenting of malignant bile duct stenoses may eliminate or at least relieve jaundice and pruritus. Single stenting is sufficient for distal bile duct stenoses. In patients with liver metastasis and life expectancy of <6 months, temporary plastic prostheses with 4-6-month patency are sufficient. When the prognosis is for >6 months, self-expanding permanent metal stents, with their significantly longer patency, are superior. In hilar tumors, obstruction of plastic prostheses occurs earlier than in distal bile duct stenoses. Thus, patients with Bismuth II-IV tumors benefit from self-expanding metal stents. These may be inserted by an endoscopic, retrograde approach, percutaneously, or by a combined rendez-vous maneuver. The superiority of bilateral vs unilateral stenting has yet to be proven in Bismuth II-IV tumors. Photodynamic therapy followed by stenting appears to improve survival rates by delaying stent occlusion rather than by regression of the tumoric disease itself. 相似文献
16.
金属内支架置入治疗胃十二指肠恶性梗阻 总被引:8,自引:4,他引:4
目的评价金属内支架置入术治疗胃或十二指肠恶性梗阻的效果. 方法 2002年10月~2004年11月,24例恶性肿瘤(胃癌19例,胰腺癌4例,胆管癌术后1例)引起的胃或十二指肠梗阻的患者,在X线透视下,用内镜将金属内支架置入胃或十二指肠狭窄部位. 结果 24例金属支架均置入预定的部位.术后第1天进流质,第3天开始进半流质.无置入支架引起的消化道穿孔、出血等并发症.21例在1~24个月的随访期间,仅2例出现梗阻.无金属支架移位. 结论在胃或十二指肠恶性梗阻部位置入金属内支架,是一种安全有效的治疗胃或十二指肠恶性梗阻方法. 相似文献
17.
Background: Self-expanding metallic mesh stents are designed to remain patent longer than polyethylene (PE) stents, which generally clog
in 3 to 4 months. Though more expensive, metal stents may therefore be a better choice for malignant strictures.
Methods: From January 1991 to October 1995, we performed ERCP in 212 patients with malignant or benign strictures, and 34 ultimately
had insertion of a metallic stent. These stents were placed by the percutaneous transhepatic route in 17 patients and endoscopically
in 17.
Results: Metallic stent insertion was successful in each case and relieved the preoperative jaundice and cholangitis. There were no
procedure-related deaths; complications were pancreatitis (one) and hemorrhage (one). Overall stent patency was 6.2 months.
Three of 34 stents occluded due to tumor ingrowth at 3, 4.5, and 8 months and were treated by placing a new PE stent through
the blocked metal stent. The remaining 31 stents remained patent until patient death (n= 15, mean survival = 4.9 months) or are still open (n= 16, mean patency = 12.2 months).
Conclusions: Self-expanding metal stents provide effective palliation of malignant biliary strictures and should be considered an alternative
to open surgery. Metal stents remain patent much longer than PE stents and usually a single session of metal stenting can
palliate biliary obstruction for life.
Received: 20 March 1996/Accepted: 9 May 1996 相似文献
18.
Comparison of stent placement and colostomy as palliative treatment for inoperable malignant colorectal obstruction 总被引:2,自引:0,他引:2
Tomiki Y Watanabe T Ishibiki Y Tanaka M Suda S Yamamoto T Sakamoto K Kamano T 《Surgical endoscopy》2004,18(11):1572-1577
Background Stent placement is a useful palliative treatment for inoperable acute malignant colorectal obstruction. However, data comparing
stent placement with colostomy are scarce.
Methods We compared the clinical outcome of 18 patients who had stent placement and 17 patients who underwent only colostomy.
Results The postoperative hospital stay was 22.3 days for stent placement compared with 47.4 days for colostomy (p=0.016). The duration to readmission was 129.2 days for stent placement and 188.4 days for colostomy. The estimated duration
of primary stent patency was 106 days. Mean survival period was 134 days in patients with stent placement and 191 days in
patients with colostomy.
Conclusion Postoperative hospital stay was shorter in patients with stent placement but duration to readmission and survival were longer
in patients with colostomy. However, stent placement increases the option of palliative treatment and is an effective treatment
contributing to improving quality of life.
Online publication: 13 October 2004 相似文献
19.
恶性梗阻性黄疸介入治疗与手术引流比较 总被引:7,自引:3,他引:4
目的比较恶性梗阻性黄疸经皮经肝穿刺胆管引流(PTCD)与手术引流的疗效。方法收集不能手术切除的恶性梗阻性黄疸患者资料131例,其中102例常规经皮经肝穿刺胆管造影后放置内、外引流管或者留置金属内支架(介入治疗组),解除胆管梗阻;另29例为同期术前判断有手术切除可能而术中证实不能行根治性手术或者不同意行PTCD治疗患者(手术引流组),行开腹胆管内、外引流术。比较2组治疗前、后总胆红素变化、术后并发症发生情况、住院时间以及住院费用。结果介入治疗组穿刺成功率100%,与手术引流组比较,介入治疗组平均胆红素下降50%时间、术后总并发症发生率差异均无统计学意义(P0.05),但平均住院时间和平均住院费用均少于手术引流组(P0.05)。结论与手术引流比较,介入治疗具有微创性,可以重复操作,明显缩短住院时间,减少住院费用,且并不增加并发症发生率,并可以为后续治疗创造条件,是不能手术切除恶性梗阻性黄疸治疗的首选方法。 相似文献
20.
Park JK Lee MS Ko BM Kim HK Kim YJ Choi HJ Hong SJ Ryu CB Moon JH Kim JO Cho JY Lee JS 《Surgical endoscopy》2011,25(4):1293-1299