胆道内支架治疗胆胰恶性肿瘤

Interstents Drainage for Malignant Biliary and Pancreatic Tumors

目的探讨胆道内支架引流治疗胆胰恶性肿瘤的临床疗效。方法无手术指征的103例胆胰恶性阻塞性黄疸患者,行内镜下胆管支架引流,包括:经内镜鼻胆管引流术(ENBD组)11例,经内镜逆行塑料导管胆管引流术(ERBD组)45例,经内镜金属支架逆行引流术(EMBD组)47例。结果胆道引流效果满意91.3%,一般6.8%,无效1.9%;103例平均生存时间(227±135)d,ENBD组(184±56)d,ERBD组(226±73)d,EMBD组(238±136)d,3组比较无显著差异(P>0.05)。胆道引流术后通畅时间EMBD组为(214±120)d,明显优于ERBD组的(143±46)d和ENBD组的(152±74)d(P<0.05)。结论应用胆道支架治疗胆胰恶性肿瘤引起的梗阻性黄疸是一种简便、安全、有效的姑息性治疗手段。

Objective To explore the clinical effects of iterstents drainage for malignant biliary and pancreatic tumors. Method In the 109 malignant biliary and pancreatic tumor patients without radical resection indication, endoscopic nosal biliary drainage （ENBD）was done in 11 cases, endoscopic retrograde biliary drainage（ERBD） was done in 45 cases, and endoscopic metal retractor biliary drainage （EMBD）was done in 47. Results The bile duct drainage effct was satisfied of 91.3%, fair of 6.8%, and invalidof 1.9%. The mean survival time was（227 ± 135 ）days, and there was no significant difference in the 3 groups ,which was（ 184 ± 56） days in ENBD, （226 ± 73 ） days in ERBD, and （238 ± 136） days in EMBD respectively, P 〉 0.05. The unobstructed time of bile duct was（214 ± 120） days in EMBD, which was significantly longer than （ 143 ± 46） days of ERBD and （ 152 ± 74） days of ENBD, P 〈 0.05. Conclusion The iterstents drainage is a simple, safe and effective method for palliative therapy of malignant biliary and pancreatic tumors.