金属内支架胆道引流术治疗恶性梗阻性黄疸(附41例报告)

Biliary Drainage Treatment of Malignant Obstructive Jaundice with Metallic Stent (A Report of 41 Cases)

观察金属内支架对恶性梗阻性黄疸的治疗作用。方法恶性梗阻性黄疸患者４１例中２６例经ＰＴＣＤ置放金属内支架，１５例外科直视手术下置放。置放的支架有进口和国产两种。结果技术成功率１００％，１例介入法放置术后２ｈ出现胆道出血，经处理后出血停止。３例置放术后出现胆道感染，１．５月死亡。其余病例无严重并发症。术后患者全身状况改善，血清总胆红素术前平均２２５．２μｍｏｌ／Ｌ，术后３～１０周内（平均６．５周）降至正常。随访时间最短为１．５月，最长为２５个月．生存期为１．５～２５月，中位生存期６．５月。术后存活半年以上者１２例。其中３例于术后６、７、１４个月再次出现梗阻性黄疸。结论胆道置放金属内支架具有手术简单、疗效显著的优点。

Purpose To observe the effect of metallic stent in malignant obstructive jaundice. Methods Among 41 cases of malignant obstructive jaundice,the stent was released through with PTCD(26 cases)and surgery(15 cases).The stent was made in abroad or China. Results The technical successful rate was 100%,one case had breeding after release of the stent with PTCD on two hours.The breeding was controlled by effective clinical treatment.3 cases had infection after release of the stent.Other cases had no severe complications.All conditions improved progressively after operation.The serum bilirubim level was remarkably declined in 3-10 weeks (ave rage 6.5 weeks) from 225.2 μmol/L to normal. The living period were 1.5-25 months,average was 6.5 months.The 12 cases was alive longer than half a year.Obstructive jaundice reappeared after release of stent in 6,7 and 14 months in 3 patients. Conclusions Treating obstructive jaundice with a metallic stent is relatively simple and effective.It is a better method for treating malignant obstructive jaundice.