高位胆管梗阻的介入治疗和近期疗效分析

Short term efficacy of interventional therapy for hilar biliary obstruction

目的回顾性分析高位梗阻性黄疸患者介入治疗方法及近期疗效。方法100例接受经皮肝穿刺胆汁引流或胆道支架置入治疗的高位梗阻性黄疸患者,其中胆管癌39例,转移瘤22例,肝移植后胆管病变18例,原发性肝癌15例,胆囊癌6例。测定术前,术后3～7d、8～14d血胆红素水平并进行显著性检验。结果79例行单纯外引流或内外引流,21例行胆道支架置入术,所用支架4种31枚。术前血清胆红素含量与术后3～7d胆红素水平差别有显著性(P<0.05),与术后8～14d胆红素水平比较有非常显著的差异(P<0.01)。结论介入治疗高位梗阻性黄疸方法简单、近期疗效满意。

Objective To analyze the method and short term efficacy of interventional therapy for hilar biliary obstructive jaundice. Methods 100 consecutive patients with perihilar biliary obstruction admitted before May 2004 were treated with percutaneous transhepatic biliary drainage （PTBD）or placement of metallic stents. Among them, 39 patients were found with bile duct cancer, 6 with adenocarcinoma of gallbladder, 22 with metastatic carcinoma, 15 with primary liver carcinoma and 18 with bile duct strait after liver transplantation. Serum total bilirubin before operation and 3 - 7 days,8 - 14 days after procedure were analysed by t test. Results 79 patients with PTBD（including simple external drainage and combined internal and external drainage）,and 21 patients with stents placement （including 31 stents of 4 different kinds） were all carried out successfully. There were significant differences in serum total bilirubin before and 3 - 7 days,8 - 14 days after the procedure, P 〈 0.05 vs P 〈 0.01. Conclusion Interventional therapy is simple, safe, and effective for hilar biliary obstruction,the latter showed more significance than the former with short term satisfection. （J Intervent Radiol, 2006, 15： 491-493）