经皮肝胆管引流术治疗胆管恶性病变的并发症

Complications of Percutaneous Transhepatic Biliary Drainage for Malignant Diseases

目的:分析经皮肝穿胆管造影及引流术(PTBD)治疗恶性梗阻性黄疸(MOJ)的并发症发生率及原因,并探讨相关的预防措施。方法:复习311例PTBD治疗MOJ的病例资料,统计并发症种类及病例数,分析并发症的发生原因。结果:PTBD治疗MOJ311例,共发生各种并发症165例(53.1%),其中胆管感染46例(14.8%),引流管移位38例(12.2%),引流管堵塞31例(10%),瘘口渗漏20例(6.4%),瘘口皮肤感染18例(5.8%),胆管出血6例(1.9%),胆汁性腹膜炎2例(0.6%),胆汁引流过多2例(0.6%),肝脓肿1例(0.3%),气胸1例(0.3%)。结论:PTBD治疗MOJ具有较高的并发症发生风险,严格掌握PTBD适应证和禁忌证,及时处理引流管相关问题,可减少和控制严重PTBD并发症的发生。

Objective：To interpret the incidence of complications of percutaneous transhepatic biliary drainage （PTBD） for malignant obstructive jaundice （MOJ）. Methods：The medical records of 311 patients who had undergone PTBD for MOJ were reviewed with attention to the complications resulting from this mode of drainage and assessment of preventive methods. Results：Various forms of complications were observed in 165 cases of all patients who had undergone PTBD. The incidence of the complications was 53.1 % in this group. Complications of higher incidence were infections of biliary tract （14.8 % ）, drainage tube dislodgement （12.2% ） and tube emphraxis （ 10 % ）. Conclusion： PTBD carries a high risk of complications in patients with MOJ. Severe complications can be avoided or reduced by obeying the indications and contra-indications and handling the problems related to drainage tube without delay.