经十二指肠镜放置胆管支架治疗胆总管疾病29例

目的观察不同胆总管疾病经内镜下胆管支架置入引流术及支架种类和置入方法选择对置入后疗效的影响。方法对29例分别患有胆总管良性狭窄及恶性狭窄的患者,分别给予双塑料支架或金属支架置入引流术,观察疗效,并随访3～18个月。结果 29例患者完成胆管支架置入引流术,8例良性狭窄给予双塑料支架置入,半年后100%治愈;恶性狭窄给予金属支架置入,术后第1天结合胆红素下降（39.4±1.8）mol/L,术后第7天结合胆红素下降（164.8±2.2）mol/L,患者存活时间40d～3年,平均存活时间226d。结论根据不同胆总管疾病需选择不同的支架种类和不同的置入方法,支架种类和置入方法的正确选择是取得预期疗效的前提。

Endoscopic implantation of biliary stent in the treatment of 29 cases of common bile duct disease

Objective To observe the influence of stent type and implantation method on the efficacy after implantation,which was used in endoscopic biliary stent drainage treating different common bile duct diseases. Methods 29 cases of patients with benign or malignant stricture of common bile duct were respectively given double plastic stent or metal stent drainage.Then they were observed with efficacy and were followed up for 3 to 18 months. Results The biliary stent drainage was completed in 29 patients,8 cases of patients with benign stricture were given double plastic stent,and they were 100% cured after half a year.Patients with malignant stricture were given metal stent,and the direct bilirubin decreased for （39.4±1.8） mol/L on the first day after operation,it decreased for （164.8 ±2.2） mol/L on the seventh day after operation.The survival time of patients was between 40 days to 3 years,the average survival time was 226 days. Conclusion Different common bile duct diseases need different stent type and implantation method,the correct choice of stent type and implantation method is a premise to achieve the desired effect.