恶性梗阻性黄疸的内引流治疗

INTERAL BILIARY DRAINAGE TREATMENT OF MALIGNANT OBSTRUCTIVE JAUNDICE

目的 探讨内镜下塑料内支撑管引流对恶性梗阻性黄疸的治疗效果。方法 不能手术根治的恶性低位梗阻性黄疸病人 12 1例 ,其中 45例行内镜下塑料内支撑管引流 ,76例行胆肠吻合内引流术 ,比较两组病人术前条件、术后胆红素下降速度、医疗费用、住院时间、近期并发症、反流性胆管炎及生存时间的变化。结果 内支撑管引流组明显减少住院时间、降低医疗费用、减少近期并发症 ,而胆红素下降速度、反流性胆和炎的发生率及生存时间无明显变化。结论 内镜下塑料内支撑管引流具有病源选择广、微创安全。

Objective To evaluate the efficacy of endoscopic drainage of malignant obstructive jaundice with plastic endoprosthesis.Methods One-hundred and twenty-one patients of distal malignant biliary stricuture with no indication for radic operation were retrospectively evaluated,forty-five of 121 underwent plastic endoprosthetic procedure and 76 patients were subjected to biliary-enteric anastomoasis,the patient groups were comparable with regard to preoperative condittions,serum bilirubin decline,early complications,cumulated hospital days,cost,median survival,refulx-cholangitis.Results Endoprosthesis group was superior to biliary-enteric anastomosis group in reduction of early complications,hospital stay and cost;similiar to the latter in serum bilirubin decline,reflux-cholangitis,and median survival.Conclusions Endoscopic drainage with plastic endoprosthesis will be uesd widely thank to its minimally invasion,ease of execution and low cost