经内镜胆道支架置入术在肝门部胆管癌姑息性治疗中应用优劣势分析

目的：探讨经内镜胆道支架置入术姑息性治疗肝门部胆管癌的临床优劣势。方法：回顾性分析我院2013年1月～2015年1月收治的68例经内镜胆道支架置入术姑息性治疗肝门部胆管癌患者临床资料，设为内镜组。同期将我院收治的62例行经皮经肝穿刺胆道支架置入术治疗肝门部胆管癌设为经肝组。比较两组患者置入成功率、术后并发症及肝功能方面的差异。结果：内镜组患者胆道支架置入成功率为82.4%低于经肝组95.2%；内镜组患者术后胆道感染、胰腺炎发生率分别为22.1%、8.8%高于经肝组4.8%、0%，胆道出血发生率为1.5%低于经肝组19.4%，而内镜组肝脓肿发生率无明显差异；治疗后内镜组患者ALT、TBil显著下降。结论：经内镜胆道支架置入术姑息性治疗肝门部胆管癌效果显著，其置入成功率高，胆道出血少，有效改善患者肝功能，但其胆道感染及胰腺炎的发生率较高，而经皮经肝穿刺胆道感染及胰腺炎发生较少。

Endoscopic biliary stent placement in hilar bile duct cancer palliative therapy application analysis of advantages and disadvantages

Objective To explore the clinical advantages and disadvantages of endoscopic biliary stents in the palliative treatment of hilar cholangiocarcinoma. Methods The clinical data of 68 patients with hilar cholangiocarcinoma treated by endo-scopic biliary stent implantation were retrospectively analyzed. 62 cases in January 2013-2015 year in January in our hospital were treated with percutaneous biliary stent placement for the treatment of hilar cholangiocarcinoma. The differences of suc-cessful rate, postoperative complications and liver function were compared between the two groups. Results Slightly lower than the incidence of liver abscess group liver group outcome of endoscopic biliary stent placement success rate was 82.4%lower than the liver group was 95.2%, compared with statistical difference;endoscopic groups of patients with postoperative infec-tion of biliary tract, pancreatitis incidence rate was 22.1%, 8.8%higher than the 4.8%, 0%, biliary tract bleeding rate was 1.5%lower in the liver group 19.4%, compared with a significant difference, and endoscopic group was 0%after liver was 1.6%, there was no statistical difference;treatment after endoscopic group alt, TBIL decreased significantly, compared with statistical dif-ference, but the slightly lower than the same period in the control group, no significant difference. Conclusion The endoscopic biliary stenting palliative therapy of hepatic hilar cholangiocarcinoma effect significantly, its placement and high success rate, biliary tract bleeding, effectively improve the liver function of patients, but a higher incidence of the infection of biliary tract and pancreatitis, and percutaneous transhepatic biliary tract infection and acute pancreatitis occurred less frequently.