PTCD治疗梗阻性黄疸137例分析

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

目的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%。引导管放置时间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 Doppleruhrasound-guided percutaneoustranshepatic cholangial drainage （PTCD） in order to improve success rate and reduce the incidence of complications in the treatment of obstructive jaundice. Methods PTCD was performed in 137 patients with obstructive jaundice caused by biliary calculi carcinoma of the gallbladder and hepatic metastasis. Altogether 147 tube drainages were carried out in all the patients. The segmental biliary duct of the left hepatic lobes for PTCD was more effective compared with other ways. Results The success rate of single drainage of the bile duct was 98.5% and that of twice drainages was 100%. The tube was inserted to the target biliary tract for 3 days to 186 days. Complications appeared in 6 patients （4.4%）. Conclusions The color Doppler ultrasound-guided PTCD is effective, safe and convenient, and can be regarded as a priority decompressive method for biliary passage on obstructive jaundice.