恶性梗阻性黄疸合并十二指肠梗阻治疗中内支架的应用

目的探讨经口置入十二指肠支架、后经皮肝穿刺置入胆道内支架的方法,评价金属支架在治疗恶性梗阻性黄疸合并十二指肠梗阻的作用。方法恶性梗阻性黄疸合并十二指肠梗阻病例12例。在透视监视下,使用介入放射学方法经口置入12个十二指肠自膨式金属支架,经皮肝穿通过十二指肠支架网眼置入11个胆道自膨式金属支架、单纯置入外引流1个。结果12例病人十二指肠支架置入均成功、同时11例胆道支架置入成功,1例导管不能通过胆道阻塞段仅放置胆道外引流管,随访期间,病人术后均能正常进半流质事物,黄疸基本消退,疗效满意,本组无严重并发症发生。结论介入放射学置入金属内支架是一种简单、有效的治疗方法,对不能手术的恶性梗阻性黄疸合并十二指肠梗阻有很好的缓解作用。

Application of metallic self-expanding stent in the treatment of malignant biliary obstruction associated with duodenal obstruction

Objective To explore the methods of implanting duodenal metallic stent via mouth,then percutaneous implanting biliary stent,to evaluate the effectiveness of metallic self-expanding stent in palliation of malignant biliary obstruction associated with duodenal obstruction.Methods In all 12 cases,with interventional procedure under fluoroscopic guidance,12 duodenal self-expanding metallic stents were implanted through the mouth,11 percutaneous biliary self-expanding metallic stents were implanted through the holes of stents,1 outer draining was done.Results In 12 cases,all duodenal stents and 11 biliary stents were implanted successfully.The outer biliary drainage was performed in 1 patient because the catheter could not go through the obstruction.During follow-up,all patients were able to take semi-liquid food,the jaundice was alleviated,and the result was satisfactory.No major complication occurred in all cases.Conclusion The implantation of metallic self-expanding stent was a simple and effective method which offered good palliation for inoperable malignant biliary obstruction associated with duodenal obstruction.