胆道良性狭窄金属支架置入术后并发症及其处理

Complications of metal stent placement for benign biliary tract stricture and their management

目的探讨金属支架置入治疗胆道良性狭窄的并发症。方法随访5例胆道良性狭窄应用金属支架治疗的病人,由于反复出现寒战发热,合并支架内结石形成,胆管阻塞,其中4例行手术取出支架。结果4例病人手术取出金属支架,术中见金属支架被胆泥堵塞,胆管壁黏膜破坏,支架取出困难;行胆肠吻合胆管内置管引流。2例病人因置入金属支架后反复胆管炎,胆汁性肝硬化,肝功衰竭死亡。结论金属支架不适合应用于良性胆道狭窄。

Objective To explore the complications of metal stent placement for benign biliary tract stricture. Methods The clinical data of 5 patients with benign biliary tract stricture treated with metal stent placement in our hospital were retrospectively analyzed. Results All the 5 patients developed cholangitis. Of the 5 patients, 2 died because of biliary cirrhosis and liver failure and 3 had to be reoperated on to take out the metal stent. Chol-mud clogging and breakdown of the mucosa of biliary duct were found during the operation. Choledecojejunostomy and T-tube drainage were performed once again. Conclusions Metal stent placement is not appropriate for treatment oI benign biliary tract stricture.