左右肝管同时狭窄的高位胆管梗阻单双支架治疗的对比性研究

Comparative Study of the Singular and Dual Stent Therapy in the Cases of Upper Biliary Obstruction of Both Right and Left Hepatic Ducts

目的分析左右肝管同时狭窄的高位胆管梗阻病例行胆管内双支架放置治疗的临床应用价值。资料与方法29例肝门部胆管梗阻患者,单支架放置13例,双支架放置16例。结果单、双支架放置成功率分别为100%、93.75%(P>0.05);术后胆红素下降率分别为58.10%、74.63%(P<0.05);6个月、1年的生存率分别为78.82%、38.43%和88.17%、45.16%(P<0.05);并发症发生率为19.77%、23.10%(P>0.05)。结论左右肝管同时狭窄的高位胆管梗阻,双支架放置治疗比单支架放置治疗能更有效地解除黄疸,延长生存期,值得临床推广应用。

Objective To comparatively discuss the curative effects and analyze the clinical value of the singular and dual stent therapy in the cases of upper biliary obstruction of both right and left hepatic ducts. Materials and Methods In the 29 cases of hepatic hilar biliary obstruction, 13 cases were placed singular stent, while 16 cases were placed dual stent. Results The success rate of singular and dual stent placement was respectively 100% and 93.75% （P 〉 0.05）, the decent rate of bilirubin after operation was 58.10% and 74.63 % （ P 〈 0.05 ） ; the six months＇ and one year＇ s survival rate were 78.82 %, 38.43 % and 88.17%, 45.16% （P 〈 0.05） ;the rate of complication occurrence was 19.77% and 23.10% （ P 〉 0.05）. Conclusion In the cases of upper biliary obstruction of both right and left hepatic ducts, dual stent therapy is better than singular stent therapy in releasing icterus and extending subsistence, Therefore, the dual stent therapy is worthy to be generalized in the correlative field.