恶性胆道梗阻内镜治疗体会

Therapeutic experience ofendoscopic biliarydrainage for malignant bile duct obstruction

目的探讨经内镜胆道内支架置入术对各种恶性胆道梗阻的治疗效果。方法 31例患者均行经内镜逆行胰胆管造影术(ERCP),根据不同情况分别置入金属或塑料支架引流,并随访观察。结果31例均一次成功置入支架,其中金属支架14例,塑料支架17例,总胆红素从(321.82±40.63)umol/L一周后下降到(120.51±18.76),直接胆红素从(251.27±38.74)umol/L一周后下降到(101.49±16.38)umol/L(P<0.01)。结论通过十二指肠镜进行胆道支架置入术是姑息治疗恶性胆道梗阻的有效方法。

Objective To investigate the therapeutic effect of ERBD（ Endoscopic retrograde biliary drainage） or EMBE（ Endoscopic metal biliary endoprothesis） in the treatment of malignant bile duct obstruction.Methods 31 patients with malignant biliary obstruct firstly received ERCP（ Endoscopic retrograde cholangiopancreatography） examination. Appropriate methods（ EMBD or EMBE） were performed on them according to the patients ＇conditions. After that,outcomes were performed and evaluated. Results 31 patients underwent ERCP and embedded with biliary stents successfully. 31 cases of bile duct obstruction were drained with EMBE（ 14cases） and ERBD（ 17cases） respectively. The total bilirubin dropped significantly from（ 321. 82± 40. 63） μmol / l to（ 120. 51 ± 18. 76） μmol / l. The direct bilirubin was also reduced dramatically from（ 251.27 ± 38. 74） μmol / l to（ 101. 49 ± 16. 38） μmol / l（ P〈0. 01）. Conclusions These results indicate that endoscopic biliary drainage could provide adequate relief and have definite therapeutic effect of various malignant biliary obstruct.