经皮肝穿刺胆道内支架植入治疗恶性胆道梗阻64例

目的：总结经皮肝穿刺胆道内支架植入治疗恶性梗阻性黄疸的经验，探讨其临床疗效及价值。方法：64例患者均采用X线透视下经皮肝穿刺胆道内支架植入术治疗恶性梗阻性黄疽。根据梗阻部位的不同解剖决定放置支架的方式。结果：64例患者中，50例植入单支支架于肝总管或(和)胆总管，14例植入2支以上支架于总管和分支胆管，其中2例肝内胆管支架的桥接通过肝实质。58例患者2周内血清胆红素降低75％以上。结论：经皮肝穿刺刺内支架植入是治疗恶性胆道梗阻性的有效方法。

Percutaneous biliary drainage and stent placement for malignant biliary obstruction

Objective To summarize the experiences of treating malignant obstruction jaundice by percutaneous transhepatic biliary stent implantation,and discuss its clinical effect and value.Methods Sixty-four patients with malignant obstruction jaundice treated by percutaneous transhepatic biliary stent placement under fluoroscopy.The ways of stent placement is based on the morphology of pathological changes of bile ducts.Results Single stent is implanted in the common hepatic duct or(and)the common bile duct of 50 patients,2 or more stents are implanted in the common duct and its branches of 14 patients,2 of them connect the branches by a stent through the hepatic parenchyma.The serum bilirubin level was remarkably declined(>75%)after 2 weeks in 58 cases.Conclusion Percutaneous transhepatic biliary stent implantation is an effective therapy for malignant biliary obstruction.