金属支架治疗胆道恶性梗阻

Use of metal stents in treatment of malignant biliary obstruction

目的探讨金属支架治疗胆道恶性梗阻的价值和适应证。方法回顾性分析15例植入胆道金属支架治疗不能手术切除的胆道恶性梗阻患者的临床转归,其中胰头癌8例,肝门胆管癌5例,胆囊癌2例。结果15例患者金属支架均植入成功,术后2周内血清胆红素恢复正常8例(53.3%)、明显减退3例(20.0%)、缓慢减退4例(26.7%)。中位生存时间为12个月,一年生存率46.7%,两年生存率13.3%。结论对不能切除的胆道恶性梗阻患者放置胆道金属支架操作较简单、痛苦少、并发症少,而且减黄效果好,是一种较为理想的姑息性疗法。

Objective To discuss the value and indication of metal stents in the treatment of malignant biliary obstruction. Methods Clinical outcomes of 15 inoperable patients with malignant biliary obstruction who received biliary implantation of metal stems were analyzed retrospectively. They included carcinoma of pancreas head in 8 patients, portal carcinoma of biliary duct in 5 patients and carcinoma of gallbladder in 2 patietns. Results Stent implantation was successful in all 15 patients, in whom serum bilirubin restored normal in 8 patients （53. 30/oo）, dropped markedly in 3patients （20.0%）, and dropped gradually in 4patients（26. 7%）. Median survival was 12months, 1- year survival was 46. 7%, and 2-year survival was 13.3%. Conclusions Metal stant implantation is safe and less painful palliative treatment for inoperable patients with malignant biliary obstruction, with fewer complications and a better effect of reducing jaundice.