超声在胆道内支架术前后的应用价值

目的　评价超声在胆道内支架术前后的临床应用意义。方法　回顾性分析 3 8例次梗阻性黄疸行胆道内支架术前、后的超声结果 ,并与电子十二指肠镜或手术比较。结果　支架置放成功率 :肝门部梗阻为10 0 % (15 / 15 ) ,胆总管梗阻 10 0 % (12 / 12 ) ,壶腹部梗阻 83 % (5 / 6) ,乳头部梗阻 2 0 % (1/ 5 ) ;良性病变 10 0 %(8/ 8) ,恶性病变 83 .3 % (2 5 / 3 0 )。总成功率 86.8%。置放成功率在不同梗阻部位组内、乳头部组与其他组间差异具有非常显著性意义 (P <0 .0 1) ,良恶性病变组间成功率的差异无显著性意义 (P >0 .0 5 )。术后超声诊断胆道感染 1例 ,支架内阻塞 2例 ,1例胆总管下段“鸟嘴样”再狭窄超声误诊为支架内阻塞。结论　胆道支架术前超声对支架置放成功与否有重要的临床价值 ,术后超声可早期发现并发症。

Clinical value of ultrasonography before and after stent implantation

Objective To evaluate clinical value of ultrasonography before and after stent implantation in the patients with obstructive jaundice.Methods Ultrasonic findings before and after stent implantation in 38 patients with obstructive jaundice were analyzed respectively,and location and pathological natures of the obstruction were compared with those of stent implantation.Results Stent implantation was successfully achieved in all the cases with hilum (15/15,100%) and common bile ducts obstruction(12/12,100%),ampulla of Vater (5/6,83%) ,and duodenal nipple(1/5,20%).A success rate of stent implantation was 100%(8/8) in benign lesions,and 83.3% (25/30) in malignant ones.The total success rate was 86.8%.The significant difference was found between the obstruction location and success rate of stent implantation ( P < 0.01 ),but no significance was shown between obstructive nature (benign or malignant) and the success rate of stent implantation( P > 0.05 ).Conclusions Ultrasonography not only contributes to diagnosis of location and pathological nature of the obstruction for successful stent implantation but also explores complications early.