恶性梗阻性黄疸的内支架及PCS化学药物治疗

目的：探讨恶性梗阻性黄疸的内支架植入术后，动脉药盒植入术局部治疗的价值。材料和方法：３６例均已不能或不宜行外科手术治疗的恶性梗阻性黄疸病人，其中肝门区肿瘤２５例（肝门原发性肝癌１２例，肝门转移性肝癌１３例），胰头癌７例，胆管癌４例，随机分两组，一组为单纯内支架治疗（ＥＭＢＥ）；另一组为ＥＭＢＥ加ＰＣＳ治疗组。先行经皮胆管引流内支架植入术，然后行动脉药盒（ＰＣＳ）值入术，再按肿瘤生物特性及药代动力特

Malignant biliary obstruction treated with expandable metallic biliary endoprothesis (EMBE) and port- catheter system (PCS) chemotherapy

Objectve:To investigate the local value of placement of expandable metallic biliary endoprothesis(EMBE) and port catheter system (PCS) for the treatment of maligant biliary obstruction Methods:A total of 36 cases with maligant biliary obstruction conld not or did not suit for surgical treatment, including hepatic portal tumor 25 cases (12 with primary hepatocellular carciatic tumor, 13 with metastatic carcinoma), pancreatic carcinoma 7 cases, biliary carcinoma 4 cases, were divided into two groups in random One underwent EMBE, the other underwent both EMBE and PCS EMBE of percutaneous biliary drainage were placed in those patients first, then PCS were done according to characteristics of biology and pharmacoknetics Chemotherapeutic agents were infused through PCS Results:Thirty one cases were successfully placed EMBE of biliary drainage in 36 cases, amony them 13 cases underwent EMBE only, 18 cases underwent PCS on the base of EMBE Follow up time was 1 12 months In EMBE group:6 cases (50%) developed reobstruction in 1 3 months, 8 cases (61 5%) died in 2 6 months, 11 cases (84 6%) died in 12 months, In EMBE and PCS group:4 (50%) cases reobstructed after 1 3 months,6(33 3%) cases died in 2 6 months, 9 cases (50%) died in 12 months Results:EMBE combined with PCS is a more effective method compared with EMBE only in treatment of maligant biliary obstraction It is a better local therapy method The two groups have significant difference in reobstruction rate and mortality rate (P< 0 01) Conclusion:PCS in addition to EMBA is better than EBMA alone, for the treatment of malignant biliary obstruction It is a better local treatment method