内镜治疗在晚期胰腺癌姑息治疗中的作用分析

Endoscopic palliative treatment for advanced pancreatic cancer

目的评价内镜治疗在晚期胰腺癌姑息治疗中的作用。方法回顾1例晚期胰腺癌手术无法切除的典型病例。患者相继出现上消化道梗阻、梗阻性黄疸、消化道出血等问题，多次接受内镜下肠道、胆道多支架治疗及消化道止血治疗，并在经口无法正常完成内镜治疗时采用经腹壁小肠造瘘逆行进镜完成内镜逆行胰胆管造影及胆道支架置入术。结果上消化道梗阻、梗阻性黄疸、消化道出血得到治愈，直至死亡未再复发，生存期达10个月，生存质量好。结论内镜是治疗晚期胰腺癌继发消化管梗阻（胃肠道、胆管、胰管）的首选方法，安全、有效。

Objective To investigate the therapeutic effects of endoscopy for palliative treatment of advanced pancreatic cancer. Methods A typical case of un-resectable advanced pancreatic cancer was reviewed, who underwent obstruction of upper gastrointestinal tract, obstructive jaundice and alimentary tract hemorrhage subsequently. The patient received multiple placement of intestinal tract stentts, common bile duct stents and hemostatic treatment endoscopically. Because of the obstruction of upper gastrointestinal tract, jejunalostomy and retrograde endoscopy through the orificium fistulae were performed to place bile duct stents. Resuits The patient survived for 10 months with good life quality after diagnosis, obstruction of upper gastrointestinal tract, obstructive jaundice and alimentary tract hemorrhage were cured and didn＇t recur till death. Conclusion Therapeutic endoscopy, safe and effective, is the first choice for advanced pancreatic cancer complicated with obstruction of digestive tract （ including gastrointestinal tract, bile duct and pancreatic duct）.