恶性胆道梗阻ERCP表现及胆道内支架治疗

The ERCP manifestation and treatment with endoscopic biliary stenting in Malignant Biliary Obstruction

目的:评价ERCP在恶性胆道梗阻诊断及胆道内支架治疗的价值。方法:回顾性分析19例恶性胆道梗阻ERCP表现和内支架植入情况。结果:19例恶性胆道梗阻ERCP表现直接征象:胆管截断征9例、不规则偏心性或向心性狭窄9例、不规则充盈缺损1例。间接征象:梗阻近端胆总管中、重度扩张,肝内胆管扩张,呈软藤征;胆囊增大;胰管扩张等。19例共植入支架22个,一次操作成功率95.65%,低位梗阻减黄有效率达92.85%,高位梗阻减黄有效率达80.00%。结论:ERCP对于胆道梗阻定位、定性诊断有很大价值,胆道内支架引流术可以作为恶性胆道梗阻姑息性治疗的首选方法。

Objcetive：To investigate the diagnostic and therapeutic value of ERCP in malignant biliary obstruction. Methods：ERCP appearance and endoscopic biliary stenting in 19 patients diagnosed as malignant biliary obstruction were retrospectively analyzed. Resuits：Tile direct manifestations included bile duct truncation in 9 cases, irregular eccentrieal or endocentrie narrow in 9 cases, and irregular filling defect in 1 case. The indirect manifestation included median and severe dilatation in the proximal segment of common bile duct, dilatation of intrahepatic duct and pancreatic duct, augmentation of gall bladder, etc. 22 biliary stents were placed in 19 patients via ERCP. First time operation success rate was 95.65%. Jaundice release effective rate was 92.85% in low and, 80.00% in high biliary obstruction. Conclusion：ERCP has great value in the localization and qualitative diagnosis of biliary obstruction. Using endoscopic stent drainage to release malignant biliary obstruction could be choosed as the first method of palliative treatment for patients suffering from malign.ant obstructive jaundice.