胆道金属支架置入治疗肝门部胆管癌的临床研究

Metal biliary stent placement for hilar cholangiocarcinoma

目的:探讨经皮经肝胆道引流(PTBD)及经内镜逆行胰胆管造影(ERCP)置入胆道支架治疗肝门部胆管癌的临床应用价值。方法:对75例行金属胆道支架置入的肝门部胆管癌患者的临床资料进行回顾性分析。结果:PTBD组31例患者中29例实施支架放置,26例(89.7%)成功置入支架并发症发生率为6.5%,中位生存时间为26周;ERCP组44例患者中38例(86.4%)成功置入支架,并发症发生率为13.6%,中位生存时间为28周。29例单侧支架置入者和35例双侧支架置入者中位生存时间均为28周。结论:经PTBD及经ERCP的胆道支架置入对肝门部胆管癌均可获得良好的治疗效果。以PTBD方式放置时可采用单侧置入,以ERCP方式放置时应进行左右侧双支架置入。

Objective： To assess the clinical application value ofbiliary stent placement for hilar cholangiocarcinoma via percutaneous transhepatic biliary drainage （PTBD） or endoscopic retrograde cholangiopancreatography （ERCP）. Methods： The clinical data of 75 patients with hilar cholangiocarcinoma undergoing metal biliary stent placement were retrospectively analyzed. Results： In PTBD group, stent placement was performed in 29 cases and stents were successfully placed in 26 of the 29 cases （89.7%）, the incidence of complications was 6.5%, and the median survival time was 26 weeks respectively. In ERCP group, stents were successfully placed in 38 of the 44 cases （86.4%）, the incidence of complications was 13.6%, and the median survival time was 28 weeks respectively, The median survival time of both the unilateral placement group （29 cases） and bilateral placement group （35 cases） was 28 weeks. Conclusion： Biliary stent placement for hilar cholangiocarcinoma can achieve demonstrable efficacy either by PTBD or ERCP. Unilateral placement is preferred when using PTBD, while bilateral placement is recommended when performing EKCP.