应用覆膜支架治疗恶性梗阻性黄疸

目的探讨应用覆膜支架治疗恶性梗阻性黄疸的安全性及防止胆道支架再狭窄的效果。方法对30例应用FLUENCY覆膜支架治疗的恶性梗阻性黄疸患者的技术成功率、安全性及预后进行随访分析。结果接受FLUENCY覆膜支架治疗的30例患者,技术成功29例,成功率为96.7%。2例患者术后出现胆道出血,经药物治疗后出血停止;5例患者术后出现不同程度的胆系感染。2例患者失访,28例患者接受3～18个月随访,其中出现支架再狭窄的有2例,为肿瘤向支架两端生长所致;1例患者术后3周支架脱落入肠管;3例减黄效果不佳(肝门区病变),出现反复胆系感染;1例患者术后支架成角闭塞,再次置入裸支架。结论 FLUENCY覆膜支架针对非肝门区恶性梗阻性黄疸的治疗是安全可靠的,可防止肿瘤向支架网眼内生长,提高支架远期通畅率。

Covered stents in the palliation of malignant biliary obstruction

Objective To explore the safety and efficacy of covered stents in the palliation of malignant biliary obstruction.Methods 30 patients with malignant biliary obstruction treated with covered stents were evaluated by the technical success rate,safety and prognosis.Results 29/30 patients were successfully inserted one or two covered stents,technical success rate was 96.7%.2 patients experienced biliary hemorrhage and responed to hemostatics;5 patients had postprocedure cholangitis.2 patients were lost to follow up,28 patients were followed by 3-18 months.Of these patients,2 patients experienced stents restenosis caused by tumor overgrowth.1 patient had stent migration;3 patients did not have a good result in the palliation of jaundice.1 patient was reinserted an uncovered stent due to covered stent angulation after stent insertion.Conclusion Covered stents were safe and reliable in the palliation of malignant biliary obstruction.It can prevent tumor ingrowth through the wire mesh of the stent and further improve stent patency.