经内镜置支架治疗晚期恶性梗阻性黄疸

Stent placement via endoscopy for advanced malignant obstructive jaundice

目的探讨应用经内镜置支架治疗晚期恶性梗阻性黄疸的临床疗效及预后。方法回顾分析该科2003年6月～2011年6月292例经内镜置支架治疗晚期恶性梗阻性黄疸患者,对其成功率、并发症发生率、临床疗效和预后等进行分析。结果行经内镜逆行胰胆管造影(ERCP)操作成功率96.23%(281/292),术后1周复查血清生化指标,总胆红素、直接胆红素、谷丙转氨酶与谷草转氨酶均下降明显(P<0.05)。并发症主要是感染、出血、胰腺炎,并发症发生率为7.88%(23/292),经治疗后症状消失,没有操作相关的死亡发生,全组生存期为(7.21±4.68)个月,中位生存时间为7.3个月。结论经内镜置支架治疗晚期恶性梗阻性黄疸操作简单、疗效确切、并发症少,能提高患者的生存质量。

【Objective】To investigate the curative effect and prognosis of advanced malignant obstructive jaun-dice with endoscopic retrograde cholangiopancreatography (ERCP) of metal stent placement.【Methods】Two hun-dreds and ninety-two cases of malignant biliary obstruction whose biliary stent insertions received ERCP from June 2003 to June 2010 in our hospital were reviewed retrospectively. And analysis of the percent of success, incidence of complications, clinic effect and prognosis was made. 【Results】96.23% patients were successfully inserted the bile duct metal stent with ERCP. Compared with the levels of the total bilirubin, direct bilirubin, alkaline phosphatase and alanine aminotransferase before operation ,the indexes decreased one week after the stent insertion (P<0.05). The main complications were infection, hemorrhage and pancreatitis. The incidence rate of complications was about 7.88%.The patients were remission after treatment and there was no operation related dead happened. the survival time was 7.21±4.68 month, the median survival time was 7.3month.【Conclusion】The curative effect in treatment of advanced malignant obstructive jaundice with ERCP of metal stent placement is definite. This method is easily oper-ated and less complications, which improves the patient's quality of life.