胆肠吻合术后再发梗阻的介入治疗

目的 探讨阻塞性黄疸行胆肠吻合术后再发梗阻的介入治疗方法。方法 11例阻塞性黄疸行外科姑息性胆肠吻合术后再发梗阻患者，采用经皮肝穿胆道引流术（PTCD），8例加金属内支架置入术，3例置入内外引流管，并比较介入术前后总胆红素、谷丙转氨酶、谷氨酰转肽酶、碱性磷酸酶的变化。结果 11例介入手术均获得成功，3例一次性置入支架，5例引流1周后置入支架。术后黄疸消退满意，总胆红素、谷丙转氨酶、谷氨酰转肽酶、碱性磷酸酶均明显下降，与术前比较差异有显著性。结论 经皮肝穿刺胆管内金属支架置入术治疗外科胆肠吻合术后再发梗阻，并发症少，操作简单，疗效满意。

Interventional therapy for recurrent obstruction after cholecysto -intestinal anastomosis

Objective To study the interventional therapy for recurrent obstrueiton after eholeeysto - intestinal anastomosis in patients with eholestatie jaundice. Methods Eleven patients with recurrent obstruction after palliative eholeeysto- intestinal anastomosis for eholestatie janudiee underwent parcutaneous transhepatie biliary drainage. 8 patients underwent additional implantation of metallic internal stents. 3 patients underwent additional implantation of internal and external biliary draninage tubes. The dynamic changes of TBIL, GIP and AKP value before and after the therapy were comparatively analyzed. Results The interventional therapy in all patients was successful, of them. the stends of 3 eases were once implanted, the stents of 5 eases were implanted after draining for a week. Following interventional therapy, the jaundice symptoms of all patients were obviously elieved. Compared with pre - therapy, post - therapeatie TBIL. GPT and AKP value was significantly decreased and there was statistic difference. Conclusion The interventional therapy using parcutaneous transhepatie biliary drainage combined with implantation of metallic internal stent for recurrent obstruction after eholeeysto - intestinal anastomosis has many advantages such as simple procedure, less complications, and satisfactory efficacy.