经内镜置放胆道支架治疗恶性梗阻性黄疸的疗效分析

目的:探讨内镜下胆道支架置入治疗恶性梗阻性黄疸的疗效和安全性。方法:回顾性分析我院2002年1月～2005年12月经内镜置放胆道支架治疗恶性梗阻性黄疸26例的临床资料。结果:一次置放成功者24例(其中置放胆管金属支架14例,圣诞树支架10例),成功率92%。血清总胆红素由术前的(316.68±105.12)μmol/L下降为术后1周的(147.89±58.07)μmol/L,黄疸明显减轻,肝功能改善。24例均随访至死亡发现胆道金属支架平均保持通畅的时间185 d,圣诞树支架平均保持通畅的时间189 d,两者无明显差别。生存时间3～15个月。结论:经内镜置放胆道支架是治疗恶性梗阻性黄疸的一个创伤小、安全性好、并发症少的有效方法,并能提高患者生活质量及延长生存时间。

Evaluation on endoscopic retrograde biliary stent for treating malignant obstructive jaundice

Objective:To evaluate the safety and treatment effect by en- doscopic retrograde biliary stent placement drainage(ERBD)for malig- nant obstructive jaundice(MOJ).Methods:Medical records and history of the patients undergone ERBD treatment for MOJ from January 2002 to December 2005 were studied retrospectively.Results:24 out of the 26(92%)patients successfully underwent ERBD(14 cases were placed biliary metal stem;10 cases were placed Christmas-tree stent)and the serum total bilirubin content dropped from(316.68±105.12)μmol/L to(147.89±58.07)μmol/L within a week of the procedure with im- proved clinical symptoms.The follow-up revealed that the shortest pa- tency support lasted for 73 days after placing the metal stent,with a maximum of 407 days and mean patency duration of 185 days.When the two stems were compared,there was no difference with the duration of patency.The patients survived from a minimum of 3 months to a maximum of 15 months after the treatment with a mean survival of 7.6 months.Conclusion:ERBD is a round and effective treatment for MOJ with less invasion and complication.What's more,it can improve the quality of the patients' life and even prolong their life span.