经皮肝穿胆道引流术治疗梗阻性黄疸

目的 评价经皮肝穿胆道引流术治疗梗阻性黄疸的临床价值。方法 １２例梗阻性黄疸，其中９例恶性梗阻（胆管癌４例，肝门淋巴结转移压迫胆管５例０采用ＰＴＣＤ姑息性引流，３例高危良性梗阻采用ＰＴＣＤ进行术前胆道减压。结果 ４例患者行内外引流术，８例行外引流术。经１－３周引流，８例血清总胆红素降至近正常，３例下降不满意，１你无效。３例高危良性梗阻者于引流减压后安全地进行了手术，７例恶性梗阻者于ＰＴＣＤ后１周１

OBSTRUCTIVE JAUNDICE WITH PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAPHY AND DRAINAGE

To evaluate the clinical value of percutaneous transhepatic cholangiography and drainage (PTCD) for thetreatment of obstructive jaundice. Methods Twelve patients with binary obstruction were treated with PTCD,including binary carcinoma (n=4),lymph node metastasis (n~ 5),and high-risk benign binary obstruction (n=3). In 9 of the 12,binary drainagewas the primary palliative therapy, 3 of the 12 were drained for preoperative decompression. Results internal/exteral drainage wasachieved in 4 of the 12 and external catheter drainage in 8. The serum total bilirubin almost fell to normal within 1-3 weeks in 8,and no change occurred in 1. Three patients with high-risk benign binary obstruction underwent uneventful binary surgery aftersuccessful decompression. Seven patients died 1 week~3 months later,two patients are alive 4 months after catheter placement.Conclusion PTCD is a safe and effective means for palliation of malignant binary obstruction and is an important and lifesavingmethod for the treatment of highrisk benign binary obstruction.