恶性梗阻性黄疸介入治疗

目的 回顾性分析恶性梗阻性黄疸患者的介入治疗方法及近期疗效。方法62例患者,其中肝癌7例,胆囊癌10例,胆管癌15例,胰腺癌17例,肝门部转移癌13例。43例行内外引流,19例放置了胆道支架。结果 黄疸消退明显55例,不明显7例。内外引流者血清总胆红素由（450.12±113.51）μmol/L降至（240.25±107.81）L（1周）-（90.91±101.72）μmol/L（2周）。胆道内支架置入者由（410.53±98.13）μmol/L降至（270.23±115.64）μmol/L（1周）-（105.43±97.85）μmol/L（2周）。内外引流与内支架置入疗效无明显差别,早期并发症29例,死亡7例。结论 介入治疗恶性梗阻性黄疸方法简单、安全、疗效肯定。

A retrospective study of interventional therapy for malignant biliary obstruction

Objective To analyze the short- term results of interventional therapy for malignant biliary obstru-tion. Methods Sixty - two patients with malignant biliary obstruction, including 7 cases of hepatocellular carcinoma, 10 cases of carcinoma of gallbladder, 15 caseshilar biliary cancer, 17 cases of pancreatic cancer, 10 cases of carcinoma of gallbladder, 15 cases of hilar biliary cancer, 17 cases of pancreatic cancer, 13 cases of hilar metastatic cancer, were treated with percutaneous transhepatic biliary internal and external drainage (PTBIED) in forty - three patients and percutaneous transhepatic insertion of biliary stent (PTIBS) in 19 patients. Results The serum total bilirubin (STB) was reduced satisfactorily in fifty - five cases, but was not so obvious in others. STB of those receiving FTBIED was reduced from (450.12+ 113.51)funol/L before operation to (240.25 + 107.81)uMmol/L after a week, and to (90.91 + 101.72) jumol/L after two weeks. STB of those receiving PTTBS was reduced from (410.53 + 98.13)/Mmol/L to (270.23 + 115.64) unol/L after a week, and to (105.43 +97.85)fimol/L after two weeks. No significant difference can be found in the effect between PTBIED and PTIBS. Short - term complications occurred in 29 cases. The 30 days mortality was 7 cases. Conclusions Interventional therapy is simple, safe, and effective for milignant biliary obstruction.