肝门区转移癌所致梗阻性黄疸的内镜支架引流治疗临床效果分析

目的探讨内镜治疗肝门区转移癌所致梗阻性黄疸的临床应用价值。方法2006年开始随机选择自愿应用内镜治疗的晚期肝门区转移癌所致梗阻性黄疸患者，应用内镜胆道塑料内支架技术解除胆道梗阻，观察操作成功率、生存期等评价指标。共治疗肝门转移癌梗阻性黄疸患者38例，其中肝癌13例，胆囊癌3例，胃癌14例，食管癌2例，回肠腺癌1例，胰腺癌5例。结果所有患者治疗成功且临床黄疸完全消退，随访生存期92～521d，平均（185．42±104．41）d。随访观察5例患者更换胆道支架，更换时间3～14个月，平均（8．6±4．1）个月，其中支架移位1例，胆泥阻塞2例，肿瘤阻塞2例。结论内镜支架引流术是肝门区转移癌所致梗阻性黄疸的一种有效治疗方法，具有较高的治疗成功率，可以一定程度延长患者的生存期。

Endoscopic biliary stent drainage for obstructive jaundice due to hepatic portal metastatic carcinoma

Objective To investigate the clinical value of endoscopic biliary stent drainage for obstructive jaundice due to hepatic portal metastatic carcinoma. Methods Patients with obstructive jaundice arising from hepatic portal metastatic carcinoma were selected and treated with consent by plastic endoscopic bile duct stents since 2006. Success rate and survival were evaluated. A total of 38 patients with obstructive jaundice were treated and analyzed. Hepatic portal metastatic carcinoma included 13 cases of liver cancer, 3gallbladder carcinoma, 14 gastric carcinoma, 2 esophageal carcinoma, 1 ileum adenocarcinoma and 5 pancreatic carcinoma. Results Stents were successfully placed in all patients and jaundice rapidly subsided after the endoscopic procedure. Follow-up life span was 92-521 days, mean 264. 42 ± 104. 41 days. During follow-up, biliary stents were replaced in 5 patients in 3-14 months ( mean 8. 6 ± 4. 1 months) because of stent displacment in 1 case, biliary stone obstruction in 2 cases and carcinomatous obstruction in 2 others.Conclusion For patients with obstructive jaundice arising from hepatic portal metastatic carcinoma, endoscopic biliary stent drainage is effective and can prolong life span to some degree.