摘要
目的:总结胆管金属内支架放置术的临床经验和疗效分析。材料与方法:恶性梗阻性黄疸患者33例,男23例,女10例。胆管癌16例,胰头癌2例,原发性肝癌2例,肝转移瘤3例,肝门淋巴结转移瘤压迫胆管10例。本组共采用金属内支架行内引流33例,共使用6种38枚金属内支架。12例支架放置术后加局部放射治疗和化学治疗(简称放、化疗)。结果:33例采用经皮经肝穿刺置入胆管支架均获得成功,其中29例一次性植入支架,4例先行胆汁引流术(PTBD)后再放置金属内支架;9例因胆管梗阻复杂,金属支架置入后仍保留引流导管,其中3例在置管15~200天后拔除引流管。28例(84.85%)黄疸消退满意。本组中位生存期7个月,支架植入后加局部放、化疗组中位生存期10个月。结论:胆管内金属支架治疗恶性梗阻性黄疸,可用于不能手术治疗的高位胆管梗阻,支架植入后加局部放、化疗可望提高远期疗效。
Purpose: The outcome of 33 patients with malignant biliary obstruction treated with metallic stents is presented. Materials and methods: Thirty eight biliary metallic stents were placed in 33 patients with malignant biliary obstruction. They were 52—71 years old (mean=61.7); 23 were male and 10 were female. The biliary obstruction was caused by biliary carcinoma ( n =16), pancreatic carcinoma ( n =2), hepatoma( n =2), metasasis in liver ( n =3) and lymph node metastasis ( n =10). Six types and 38 metallic stents were used. After stenting, 3 cases were treated with intrastent brachytherapy, 7 cases treated with external radiotherapy and 2 patients treated with interventional radiology. Patients were followed for 6—28 months, mean11 months. Results: Stent placement was successful in all 33 cases. The same time, 4 patients were treated with plastic tube for external drainage only. The successful rate was 90%. Twenty nine patients were placed in one time, 4 cases began with plastic tube which was replaced with metallic stents after 1—2 weeks. Nine had metallic stents and plastic tube, because of complicated obstruction. The external drainage catheters were removed after 15—200 days. Three patients had stents crossing the ampulla. In 28 cases (84.85%), jaundice was resduced satisfactorily while in 5 cases with complicated biliary obstruction, the result was unsatisfactory. The median survival was 7 months. After stenting, 12 cases were treated with local chemotherapy, brachytherapy or radiotherapy. The median suvival period was 10 months. Conclusion: The metallic stent provides good palliative drainage and is well tolerated by patients. It improves the survival rate when combimed with radiotherapy, brachytherapy and chemotherapy in patients with malignant biliary obstrution.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
1997年第11期734-736,共3页
Chinese Journal of Radiology
关键词
胆管肿瘤
梗阻性黄疸
介入放射学
金属内支架
Stent Radiology,interventional Biliary obstruction, extrahepatic Biliary tumor