胆管支架和(或)引流术治疗恶性胆管梗阻30天内死亡原因分析

目的 分析胆管支架和（或）引流术治疗恶性胆管梗阻３０ｄ内死亡原因及手术有关的近期并发症，探讨更有效的临床治疗方法及手术适应证。方法 １０７例恶性胆管梗阻者实行经皮经肝穿刺担管支架和（或）引流术，术后３０ｄ内共死亡１２例，其中原发性肝癌４例，肝门淋巴结转移瘤３例，胆管癌５例，死亡率为１１．２％。结果 １２例恶性胆管梗阻者，９例放置胆管支架，其中５例同时置引流管；３例仅置胆管引流管。手术后１０例胆管梗

The causes of death in patients with malignant biliary obstruction treated by metallic stent and/or biliary drainage

Objective To analyze the causes of death in patients with malignant bile duct obstruction treated by metallic stent endoprosthesis and biliary drainage. Methods One hundred and seven patients with malignant bile duct obstruction were so treated. Of the 107 patients, 12 (11.2%) died within 30 days after operation. The bile duct obstruction in the 12 cases was due to primary hepatic cancer( n =4), metastasis of lymph nodes in hepatic hilus( n =3) and bile duct cancer( n =5). Results Five patients died of biliary infections, 4 patients died of hepatic coma, and 2 patients died of cancerous cachexia and 1 patient died of biliary tract hemorrhage.Conclusion The major causes of postoperative death of patients with biliary obstruction treated by metallic stent to support bile duct are biliary infection and hepatic encephalopathy.