内镜下平行法双金属支架引流治疗晚期肝门部胆管恶性梗阻价值探讨

Endoscopic parallel placement of biliary double metal stents for advanced malignant hilar obstruction

目的探讨经内镜平行法双金属支架引流治疗晚期肝门部胆管恶性梗阻的安全性和疗效。方法2011年1月至2012年9月对11例晚期肝门部胆管恶性梗阻的病人采用内镜平行法双金属支架引流治疗，观察疗效及安全性。结果10例成功置入左右双金属支架，全组无研究并发症及死亡病例。9例引流有效。发生2例轻微内镜相关并发症。10例双支架治疗病人中4例死亡，死亡时均无腹痛、黄疸、发热等支架阻塞迹象，生存128～185d，失访1例，其余5例病人均在随访中。结论内镜平行法双金属支架引流治疗晚期肝门部胆管恶性梗阻是安全可行的。

Objective To explore the effects and safety of endoscopic parallel placement of double metal stents on unresectable hilar malignant obstruction. Methods The clinical data of 11 patients with ma- lignant hilar obstructive jaundice due to advanced carcinoma who were treated with parallel placement of double biliary stents from January 2011 to September 2012 were retrospectively analyzed. Results Out of 11 patients, 10（90. 9% ） were successfully embedded with double biliary stents and 4 were dead during the follow-up. There was no sign of stent occlusion during the follow-up period. The survival time ranges from 128 to 185 days. One case was lost during the follow-up and 5 others are still alive. Conclusion The endoscopic parallel placement of double biliary stents is effective and safe for patients with unresectable malignant hilar obstruction.