经皮肝穿胆汁内外引流治疗恶性梗阻性黄疸

PTCD for treatment of malignant biliary obstruction

目的评价经皮经皮肝穿胆汁内外引流术治疗恶性梗阻性黄疸的临床价值。方法对30例恶性梗阻性黄疸患者,进行经皮肝穿胆汁内外引流术治疗,其中胆管癌12例,胰头癌8例,肝癌伴肝门淋巴结转移:6例,胆囊癌:4例。内外引流18例,外引流1例,失败1例。结果 PTCD成功率96.67%,血清总胆红素及转氨酶均明显下降,临床黄疸症状逐渐改善,无严重并发症发生。结论 PTCD是治疗恶性梗阻性黄疸的安全、有效的方法,特别是手术不能切除的恶性梗阻性黄疸。

Objective To evaluate the treatment of percutaneous transhepatic cholangial drainage（PTCD） in malignant biliary disease.Methods 30 case with biliary obstructive jaundice underwent PTCD.PTCD was performed under DSA guidance.There were 12 cancer of biliary duct cases,8 carcinoma of head of pancreas cases,6 hepatocellular carcinoma with metastases of the portal vein cases,and 4 carcinoma of gallbladder cases.The internal and external drainage was done in 18 case,the external drainge was done in 1 case,and 1 case was failed.Results 29 cases were successful performed.After PTCD,the total serum bilirubin level was decreased obviously.Clinical symptoms,such as jaundice and pruritus skin were relived gradually.No sever complications were observed.Conclusion PTCD for obstructive jaundice is highly effective and relatively simple in the opration.It is an ideal noninvasive treatment with high success rate and safety.