彩超引导经皮穿刺肝胆管引流术治疗梗阻性黄疸

Technical application and clinical value of color Doppler ultrasound-guided percutaneous transhepatic cholangial drainage in the treatment of obstructive jaundice

目的探讨彩超引导下经皮经肝穿刺胆管引流术(PTCD)技术应用及临床价值,旨在提高成功率,减少并发症。方法对患胆道结石、胆囊癌、胆管癌、肝转移癌引起的阻塞性黄疸137例患者在彩超引导下行PTCD,置管147根,合适胆管选择左肝高于右肝。结果1次穿刺成功率98.58%,2次成功率100%。引流管放置时间3～186d,发生并发症6例,占4.4%。结论彩超引导下PTCD是目前最为简便、安全、实用的胆道减压方法。

Objective To discuss the technical application and clinical value of color Doppler ultrasound-guided pereutaneous transhepatic cholangial drainage （PTCD） in order to improve success rate and reduce complications in the treatment of obstructive jaundice. Methods PTCD was performed in 137 patients of obstructive jaundice caused by biliary calculi, carcinoma of gallbladder, hepatic metastasis. The 147 tube drainage were carried out in all the cases. The segmental biliary duct of the left hepatic lobes for PTCD was more effective compared with other ways. Results The successive rate of single puncture of bile duct was to 98.5%,that of twice drainage was 100%. Tube were inserted to the target biliary for three days-one hundred eighty-six days. The complications were happened in 6 caces （4.4%）. Conclusion The color Doppler ultrasound-guided PTCD is effective, safe and convenient and can be regarded as a priority decompressive method of biliary passage on obstructive jaundice.