One-step palliative treatment method for obstructive jaundice caused by unresectable malignancies by percutaneous transhepatic insertion of an expandable metallic stent

瞄准：为了描述包含可扩充的金属的经皮的 transhepatic 插入的一个简单一步舞方法，在妨碍的黄疸的治疗使用的斯滕特氏印模膏(他们) 由 unresectable 恶意引起了。方法：由于 unresectable 恶意与妨碍的黄疸诊断的十四个病人在学习被包括。在这些病人的恶意是很先进的癌或老年的结果。经皮的 transhepatic 胆管造影术在 ultrasonographic 指导下面被执行。在有一个内部金属性的指南的一根导管是先进的进十二指肠以后，一他们被放在胆总管，在一个点之间在到肝的核的 Vater 和入口的乳头状的小突起以外的 1 厘米。在用就一个单身者跨越距离是困难的情况中他们，另外的斯滕特氏印模膏被放。一根排水导管在地方被离开充当一把止血钳子。在胆汁郁积和斯滕特氏印模膏明显的分辨率被证实以后，导管被移开 2 或 3 d 过程以后。结果：EMS 的一步舞插入与 24.4 min 的一过程平均数时间在所有病人被完成。从要求了 2 他们的病人， 4 需要一过程时间超过 30 min。导管的移动的吝啬的时间过程以后是 2.3 d。所有病人与 7.8 瞬间的一吝啬的后续时间死于恶意。没有 stent 相关的复杂并发症或斯滕特氏印模膏阻塞被遇到。结论：他们的一步舞经皮的 transhepatic 插入是为决定胆汁的阻塞和罐头有效地改进病人生命的质量的一个简单过程。

AIM： To describe a simple one-step method involving percutaneous transhepatic insertion of an expandable metal stent （EMS） used in the treatment of obstructive jaundice caused by unresectable malignancies. METHODS： Fourteen patients diagnosed with obstructive jaundice due to unresectable malignancies were included in the study. The malignancies in these patients were a result of very advanced carcinoma or old age. Percutaneous transhepatic cholangiography was performed under ultrasonographic guidance. After a catheter with an inner metallic guide was advanced into the duodenum, an EMS was placed in the common bile duct, between a point 1 cm beyond the papilla of Vater and the entrance to the hepatic hilum. In cases where it was difficult to span the distance using just a single EMS, an additional stent was positioned. A drainage catheter was left in place to act as a hemostat. The catheter was removed after resolution of cholestasis and stent patency was confirmed 2 or 3 d post-procedure. RESULTS： One-step insertion of the EMS was achieved in all patients with a procedure mean time of 24.4 min. Out of the patients who required 2 EMS, 4 needed a procedure time exceeding 30 min. The mean time for removal of the catheter post-procedure was 2.3 d. All patients died of malignancy with a mean follow-up time of 7.8 mo. No stent-related complication or stent obstruction was encountered. CONCLUSIONS： One-step percutaneous transhepaticinsertion of EMS is a simple procedure for resolving biliary obstruction and can effectively improve the patient＇s quality of life.