内镜下胆道内支架置入术治疗恶性胆道梗阻131例分析

目的 探讨内镜下胆道内支架置入术在治疗恶性胆道梗阻中的价值.方法 对131例恶性胆道梗阻患者行内镜下胆管内支架置入术,观察其疗效和6个月、1年、2年生存率.结果 置入金属支架55例58根,术后2～5 d 黄疸消失,45例(81.7%)血清总胆红素(TBiL)降至正常.随访31例(56.4%),6个月、1年、2年生存率分别为77.5%、33.0%、10.7%.(2)置入塑料支架 76例89根,术后3～7 d,患者黄疸明显减退,46例(60.0%) 患者血清TBiL降至正常.随访38例(50.0%),生存期70 d～11个月,6个月生存20例(26.3%),通畅期31～95 d.结论 经内镜放置胆道内支架,可有效缓解胆道梗阻,近期效果显著,是姑息性治疗恶性胆道梗阻的有效方法.

Analysis of 131 Cases with Malignant Biliary Obstruction Treated by Endoscopic Biliary Stent Insertion

Objective To investigate the role of endoscopic biliary stent insertion in treatment of malignant biliary obstruction.Methods 131 patients with malignant biliary obstruction were treated by endoscopic biliary stent insertion.Then the therapeutic effect and the survival rates at the point of 6 months,1 year and 2 years later were observed.Results (1) 55 patients were inserted with 58 metal biliary stents.The jaundice vanished 2~5 days after the operation,and the level of serum total bilirubin (TBiL)decreased to normal in 45 cases(87%).The follow-up investigation in 31 patients(56%) indicated that the survival rates of 6 months,1 year and 2 years after the operation were77.5%,33.0%,10.7 respectively.(2) 76 patients were inserted 89 plastic biliary stents.The jaundice vanished 3~7 days after the operation,and the level of serum total bilirubin returned to normal in 46 cases (60%).The follow-up investigation in 38 cases(50%)indicated that the survival periods varied from 70days to 11 months,20 patients survived in 6 months (26%) and the unobstructed period ranged from 31 days to 95days.Conclusion Endoscopic biliary stent insertion can effectively relieve malignant biliary obstruction and has significant short-time effects.So it is an effective palliative therapy for malignant biliary obstruction.