经皮经肝内支架植入治疗恶性胆道梗阻(附35例报告)

目的:探讨国产金属胆道内支架治疗恶性梗阻性黄疸的疗效和安全性。材料和方法:恶性梗阻性黄疸病人35例,均采用经皮经肝途径植入胆道支架,其中16例采用两步法植入,19例采用一步法植入,5例同时施行了左肝管的球囊扩张术。结果:支架植入后即刻造影显示支架开通良好,内引流作用显著。血清胆红素水平降至正常者21例(60%),下降超过50%但未降到正常者7例,下降未过50%者3例,无改善者3例。3例病人术后一月内死亡,16例无黄疸生存6个月以上,半年生存率53.2%,3例生存12个月以上。8例病人半年内出现支架梗阻,占23.8%。一步法和二步法两种方法植入支架的病人住院天数和总的治疗费用统计学无显著性差异。结论:国产金属胆道内支架植入疗效显著,使用安全。

Implantation of Domestic Metallic Stent in Treatment of Malignant Biliary Obstruction(35 Cases Report)

Purpose:To investigate the effectiveness and safety of domestic stent implantation in treatment of malignant biliary obstruction(MBO).Materials and Methods:35 patients with MBO in this study were received Biliary metallic stent placement via percutaneous transhepatic approach.Of them,16 cases were performed with two step way,and the other 19 cases only through one way including 5,left bile duct stricture dilated with balloon catheter at the same time.Results:Cholangiography after the procedure showed sufficuent stent patency and significant inflow of bile.Serum bilirubin level decreased to normal in 21 cases,reduced more than 50% in 7 eases and showed no changes in 3 cases,and the latters died within 30 days after stent insertion.16 cases lived more than six months without jaundice,half year survival rate was 53.8%.and 3 cases lived more than 12 mouths.Stent occlusion occured in 8 cases(23.5%) within six months.Comparason of two kinds of stent placement,no statistical differenees in hospital admission days and total therapeutic cost could be found.Conclusion:Domestic biliary metallic stent possesses good quality in releasing obstructuon jauudice safely.