胆胰管多点位引流的临床体会

目的：探讨内镜逆行胆胰管造影术（ERCP），同期置入多点位支架以姑息性解除胆胰管良恶性梗阻的可行性及疗效。方法：采用ERCP了解胆、胰管狭窄或梗阻的精确部位、范围、程度，并确定置入多点位支架。术后观察临床症状改善情况、血淀粉酶变化、黄疸消退情况、支架通畅时间及平均生存期。结果：75例病人中恶性梗阻病人多点位支架的平均通畅期为7个月，平均生存期10个月。全组未发生与操作有关的严重并发症及死亡。结论：在必要条件下，多点位支架引流对解除胆胰管良恶性梗阻比单根支架有更好的疗效、更少的术后胆管炎的发生率及黄疸消退时间。病人的支架通畅期及生存期均有所延长。

Multi-stenting Drainage in Treating Obstructing of Pancreaticobitiary Duct

To explore t he advantage of implanting stents in treati ng multiple biliary/pancreatic stenos is via endoscopic retrograde cholangiaopancr eatography. Methods: Patients underwent ERCP to precisely unde rstand the location, degree and exten t of the biliary pancreatic stenoses and t o implant the stents. Clinical improve ment change in blood amylase concentratio n, recession of jaundice, prolongation of ductal patency and mean survival time all attested to the efficacy of the pro cedure. Results: The s tents were shown to be patent for a mean duration of 7 months and the mean surv ival was 10 months after the procedure. Th ere were no severe procedure-related complications and mortality. Con clusions:The result s showed the superiority of implanting mult iple stents for relieving benign or malignant biliary/ pancreatic obstruction o ver the conventional single stent.