胆道支架放置术治疗恶性梗阻性黄疸的体会

Management of malignant obstructive jaundice by biliary stents

目的探讨胆道支架放置术治疗恶性梗阻性黄疸的安全性和有效性。方法采用自膨式胆道支架放置术治疗恶性梗阻性黄疸78例病人。术前实验室检查血总胆红素为(362.4±106.7)μmol/L,以直接胆红素升高为主[(271.9±74.3)μmol/L]。结果所有病例均成功放置支架,术中、术后无因操作原因致死病例,1～4周黄疸完全消退68例,血胆红素降到正常水平,10例血胆红素平均降至65.2μmol/L;并发症以胆道感染为主。结论胆道支架放置术治疗恶性梗阻性黄疸有效、安全。

Objective To evaluate the effect and safety of biliary stents placement in jaundice by malignant biliary obstruction. Methods Seventy-eight patients with jaundice caused by malignant biliary obstruction were treated with self expandable metallic stent,preoperative bilirubin was high [（362.4 ± 106.7） μmol/L] and directive bilirubin was （271.9 ± 74.3） μmol/L. Results Bilicary stent placement was successful in all of the cases. All treated patients were safe and their jaundice was eliminated. Postoperative bilirubin was normal in 68 cases and decreasing level （average 65.2 μmol/L） in 10 cases. Most complications in these patients were cholangitis. Conclusion Biliary stents placement is an effective and safe approach in treatment of jaundice caused by malignant biliary obstruction.