胆道梗阻经内镜引流术的体会

Endoscopic biliary drainage for biliary obstruction

目的探讨经内镜胆道引流治疗胆道梗阻的可行性和疗效.方法回顾性分析我院2003年3月～2004年10月对96例胆道梗阻病例进行103例次内镜下胆道引流的诊治经过,分析其黄疸改善情况、支架通畅率及生存期.结果操作成功率为93.6%.良性胆道梗阻者总有效率为86.7%,恶性梗阻者为88.0%.ERBD组3、6、12月生存率分别为45.8%、33.3%、0;EMBE组分别为100%、76.9%、30.7%.EMBE支架通畅率与平均引流时间均优于ERBD者(P＜0.01).结论经内镜胆道引流治疗老年人良、恶性胆道梗阻疗效确切,可达到减黄、减压、延长生存期的目的.

Objective To explore the feasibility and effect of endoscopic drainage in treating biliary obstruction. Methods Ninety-six patients with biliary obstruction underwent successfully 103 cases/times of endoscopic drainage. Nasobiliary catheterization was performed on 61 cases, stents with plastic endoprothesis on 29 cases and expandable mental stents on 13 cases. The recession of jaundice, rate of ductal patency and survival time were retrospectively analyzed. Results The success rate of endoscopic procedure was 93. 6%. The efficiency rate was 86. 7% and 88. 0% respectively in benign and malignant obstruction. The survival rate at 3,6,12 month was 45.8 %, 33. 3 %,0 respectively in ERBD group,while 100%,76. 9% ,30. 7% in EMBE group. Rate of ductal patency and mean drainage duration was significantly different between ERBD group and EMBE group（P〈0. 01 ）. Conclusion The effect of endoscopic biliary drainage is definite in relieving jaundice, decompressing and prolonging survival time.