经皮肝穿胆道支架置入治疗恶性胆道梗阻的临床研究

Clinical research of percutaneous transhepatic biliary stent placement for malignant bile duct obstruction

目的:总结经皮肝穿刺胆道金属内支架植入治疗恶性胆道梗阻的临床疗效及经验。方法:92例恶性胆道梗阻性黄疸患者,采用经皮肝穿刺肝胆管支架置入术。根据胆道梗阻狭窄的不同部位和狭窄的程度采用相应的放置方式。结果:92例患者中,91例胆道支架成功放置,其中12例放置双支架,支架扩张良好,引流通畅,血清胆红素下降明显。术后死亡2例,胆道出血3例,腹水渗漏6例,胆漏2例,支架移位1例,胆管炎9例,胆道再阻塞11例。结论对不能手术的恶性胆道梗阻性黄疸患者,经皮肝穿刺胆道内支架植入术创伤小,可提高患者的生存质量,延长生存期,是一种较为安全、有效的方法。

Objective：To investigate the effect of percutaneous transhepatie biliary stent placement for malignant bile duct obstruction. Methods： Total of 92 patients with malignant bile duct obstruction were treated with percutaneous transhepatic biliary stent placement under DSA. Results： In 92 cases,91 cases＇stents were implanted successfully,and double stents were implanted in 12 cases. The sents expand finely and draining smoothly, serum bilirubin decreased obviously,2 cases died after the operation. 3 hemobilia cases,6 hydroperitoneum percolated cases,2 bile percolated cases,1 sents shifting case,9 cholangitis cases,and 11 biliary tract blockage cases happened. Conclusion： It is a safe and effective method for inoperable malignant bile duct obstruction cases, that percutaneous transhepatic biliary stent placement has little wound, and can improve the living quality and prolong living time.