内镜下支架植入与旁路手术治疗晚期恶性梗阻性黄疸的临床研究

目的比较外科手术和内镜下支架植入对晚期恶性梗阻性黄疸的引流效果。方法回顾分析比较66例晚期恶性梗阻性黄疸患者的临床资料。结果两组患者中减黄的短期效果差异无统计学意义，但手术组的住院时间和近期并发症显著高于支架组；支架组由于支架堵塞引起胆道再次梗阻及胆管炎概率高于手术组。结论两种方法短期减黄效果相似，但支架组有较高的胆道再梗阻率。对手术风险小、预期寿命较长的患者，外科手术减黄是比较合理的选择。

Comparison study of treating the malignant obstructive jaundice with endoscopic stent insertion and bypass operation

Objective To compare the clinical outcomes between endoscopic stent insertion and bypass operation in treating the late malignant obstructive jaundice. Methods The clinical data for 66 patients treated with either endoscopic plastic stenting or surgical bypass were reviewed and analyzed. Result No significant difference was found between the two groups in terms of effectiveness. There was longer time of hospital stay and more early complications in the surgical group. However, late complications and jaundice recurred were significantly more common in the stenting group. Conclusion Both techniques are equally effective in biliary drainage, but stenting group has a higher rate of recurrent jaundice. Surgery is reasonable for patients with low surgical risks and long life expectancy.