经皮胆道内外引流及支架置入治疗梗阻性黄疸

Treatment of biliary obstruction by percutaneous transhepatic drainage and metallic stent placement

目的总结经皮肝穿刺放置引流管及金属内支架作胆汁内、外引流的临床应用价值。方法23例梗阻性黄疸患者经皮肝穿刺胆道置管内外引流后,其中12例行胆道内支架置入术治疗。结果23例黄疸均消退满意,血清总胆红素由术前147.4～648.7μmol/L降至正常或接近正常。22例恶性梗阻3个月内死亡6例,半年内死亡8例,最长生存25月,中位生存期6个月。结论经皮肝穿刺胆道置管及内支架引流是姑息性治疗手术不能切除的梗阻性黄疸的有效方法。

Objective To evaluate the percutaneous transhepatic drai na ge and bitiary stent placement as the treatment of biliary obstruction. Methods Twenty-three patients with biliary obstruction received percutaneous transhepa tic cholangiography and drainage (PTCD). And among the 23, stent placement was p erformed in 12 patients. Results All 23 patients jaundice was satisfactorily rel ieved, and total bilitrubin value was decreased from 147.4pmol/L-648.7pmol/L, the pre-procedure data, to the post-procedure data at normal level or very c lose to normal level. In 22 case of malignant biliary obsruction, the survival r ate of 3 and 6 months 70 % and 60% respectively. The median survival was 6 m onths. Conclusion The combination of metallic stent placement and local therapy are effective in the treatment of biliary obstruction which is unable to be cure d by surgical procedure.