恶性高位胆道梗阻经皮经肝胆道引流方式的疗效分析

目的：探讨恶性高位胆道梗阻患者经皮经肝胆道引流方式对术后近远期疗效影响，为临床选择适当的治疗方式提供依据。方法-回顾性分析我院108例恶性高位胆道梗阻患者，比较单侧引流（68例）和双侧引流（40例），左右肝管是否相通，引流材料对近期胆红素下降值和生存情况的影响。结果：三组术后3—5天胆红素的下降值明显，但无统计学差异（P〉0．05）。随访1—36个月，单侧组和双侧组、单枚引流管与单枚支架生存率没有显著差异（P〉0．05）。结论：恶性高位胆道梗阻以右侧入路单侧引流为主，生存期预计大于3个月，放置胆道支架，否则置入胆道引流管。

Efficacy of percutaneous transhepatic biliary drainage way for high malignant biliary obstruction

Objective：To explore postoperative decrease of bilirubin and long - term efficacy of the patients with high malignant biliary obstruction by percutaneous transhepatic biliary drainage. Methods：To retrospectively analyze postoperative bilirubin decreasing and long - term effect of 108 cases with high malignant biliary obstruction. They were divided into unilateral drainage group（68 cases） and bilateral drainage group（dO cases）. According to left and right hepatic duct is interlinked or not, drainage materials impact the recent decline in bilirubin values. Results： Bilirubin values of postoperative 3 - 5 days in unilateral and bilateral drainage group, interlinked or not, and single tube and single stent,which decreased significantly,but were not statistically different （P 〉 0.05）. All patients were followed up for 1 - 36 months,between unilateral drainage and bilateral drainage,single tube and single stent,the survival rate was not different （ P 〉 0.05 ）. Conclusion： High malignant biliary obstruction prefered unilateral biliary drainage, to puntured the right side, survival time of patients with anticipative is longer than 3 months.