经皮穿刺内支架置入联合区域性动脉化疗栓塞治疗恶性梗阻性黄疸

Biliary stents combined with transcatheter arterial chemoemboliation for treatment of malignant biliary obstruction

目的观察经皮肝穿刺胆管内支架置入联合区域性动脉化疗的方法进行栓塞治疗恶性梗阻性黄疸的疗效。方法梗阻性黄疸患者68例，采用经皮肝穿刺支架置入术（PTCD）联合肝动脉灌注化疗栓塞（TACE）观察治疗成功率、并发症及临床效果。结果PTCD成功率100％，Ⅰ期支架置入成功率78．6％（44956），Ⅱ期支架置入成功率100％（12／12）。术后并发PTCD引流管脱落2例，腹腔出血2例。随访62例（6个月-3a），平均生存时间为18．2个月。结论采用PTCD联合TACE治疗恶性梗阻性黄疸，成功率高，并发症少，可延长患者生存期。

Objective To study the effect of combined-medality therapy including biliary stents and transcatheter arterial chemoemboliation （TACE） in management of malignant biliary obstruction. Methods Sixty-eight patients with maglinant biliary obstrudction received biliary stems combined with TAcE, The rate of success, complication and clinical efficacy were followed. Results The procedure of percutameous transhepatic cholangiography and drainage （PTCD） was technically succeeded in all patients. The successful rates of stem insertion in Ⅰ stage and Ⅱ stag stent insertion were 78.6% and 100%. The complications included drainage catheter slipping out in 2 patents and bleeding in 2 patients. In the follow-up penied of 6 months to 3 years, the mean survival time was 18.2 months. Conclusion Biliary stems combining with TACE was effective to treat patients with malignant obstructive jaundice, improving life quality and prolonging survival time.