胰头癌的内镜支架引流治疗

Endoscopic stents drainage in patients with pancreas head carcinoma

目的探讨经内镜支架引流姑息性治疗胰头癌的临床意义。方法2003年8月至2007年8月对197例胰头癌患者进行内镜支架引流姑息性治疗，并观察其疗效。结果197例均伴有胆道梗阻，伴有远端胰管扩张126例，伴有胰体尾萎缩91例。放置胰管支架108例，成功率96．4％；放置胆管支架197例，成功率为99．0％。内镜治疗成功的195例术后黄疸均消失，101例疼痛患者完全缓解98例，部分缓解3例。术后24例出现血清淀粉酶升高，对症处理后恢复正常。随访率93．8％，平均生存期（373．57±157．35）d，最长生存期842d。结论经内镜支架引流姑息性治疗胰头癌是一种确实有效的方法，可以提高患者生存质量，延长生存期。

Objective To evaluate the clinical value of endoscopic palliative stents drainage in pa- tients with unresectable carcinoma at pancreas head. Methods Endoscopic stents placement was performed in 197 patients with unresectable pancreas head carcinoma, from August 2003 to August 2007, and the clini- cal data was studied retrospectively. Results Bile duct obstruction was present in all patients, in which 126 were accompanied with dilation of distal pancreatic duct, 91 with atrophy of pancrea body and tail. Stent placement in pancreatic duct was performed in 108 patients with a success rate of 96. 4% , and placement in bile duct was performed in all patients with a success rate of 99.0%. In 195 patients with successful stent placement, jaundice dissolved after the procedure. Of 101 patients who had abdominal pain, complete pain alleviation was achieved in 98, partially alleviation achieved in 3. Serum amylase level increased after the operation in 24 cases, which resumed to normal value after corresponding managements. All patients received a lifelong follow-up at mean duration of 373.57 ± 157.35 days, with a longest survival time of 842 days. Conclusion Endoscopic palliative stents drainage is safe and effective in patients with unreseetable pancreatic career, which might increase survival rate and improve life quality.