经内镜胆管支架置放技术相关问题探讨

目的探讨内镜胆管支架置放技术的，临床应用范围和操作过程中应注意的问题。方法对我院1999年8月～2006年12月经内镜放置胆管支架进行治疗的185例，临床资料作回顾性分析。结果185例均成功置管，引流总有效率达100％．恶性胆道梗阻148例，占80％（148／185），其中肝门胆管癌49例，壶腹周围癌及其他器官恶性肿瘤术后的梗阻性黄疸99例．使用胆管塑料支架96例，胆管金属支架52例；胆管结石及胆道良性病变置放塑料支架37例，占20％（37／185），其中胆管结石23例，胆道良性狭窄8例，硬化性胆管炎2例，胆道术后胆漏4例。148例恶性胆道梗阻患者经引流1周后黄疸指数明显下降．皮肤瘙痒等症状迅速改善。23例胆管结石患者经支架引流后．胆道感染症状得以控制．全身情况明显改善.4例胆漏患者经引流后治愈。结论严格掌握支架置放指征，合理选择支架型号和所需引流的胆管分支，规范操作流程是保证支架成功置放和有效引流的关键。

Exploration and discussion of the questions on the technique of endoscopic biliary stent placement

Objective To explore the range of clinical application of endoscopic biliary stent placement and the details of performance. Methods The clinical data of 185 patients implanted biliary stent with endoscope in our hospital from August 1999 to December 2006 were analyzed retrospectively. Results Biliary stents were implanted succusfully in these 185 patients and total effective rate of drainaging was 100%. Malignant biliary obstruction was found in 148 patients (accounting for 80%), including 49 patients with...