顺行性与逆行性胆管支架置入术引流肝门部胆管癌梗阻性黄疸的比较

Comparison of Anterograde and Retrograde Palliative Biliary Drainage for Obstructive Jaundice Caused by Advanced Hilar Cholangiocarcinoma

目的探讨顺行性与逆行性胆管支架置入术在肝门部胆管癌致梗阻性黄疸姑息胆道引流中的临床疗效。方法回顾2005-2015年住院治疗的113例中晚期肝门部胆管癌患者的临床资料,比较分析两种胆道引流方式的退黄效果、术后并发症、术后住院时间、术后进食时间、住院费用及生存时间等指标。结果顺行性胆管支架置入术与逆行性胆管支架置入术比较,术后进食时间、术后并发症均优于逆行性胆管支架置入术(P<0.05),术后并发症顺行性胆管支架置入术的胆道感染、胰腺炎发生率低于逆行性胆管支架置入术(P<0.05)。结论顺行性胆管支架置入术与逆行性胆管支架置入术比较,具有康复快、术后并发症少的优点,是中晚期肝门部胆管癌致梗阻性黄疸姑息胆道引流的首选方式。

Objective To evalate the clinical effects of anterograde and retrograde palliative biliary drainage given to the patients suffer from obstructive jaundice caused by advanced hilar cholangiocarcinoma. Method Retrospective analysis was performed on 113 patients＇ clinical information in our hospital who suffer from advanced hilar cholangiocarcinoma form 2005 to 2015. Comparison between the two groups in terms of effect of biliary drainage, hospital stays, postoperative feeding time, hospital cost and survival time during perioperation stage , postoperative complication was compared. Results Postoperative feeding time and postoperative complication in group under anterograde and retrograde palliative biliary drainage was less than in group under retrograde biliary drainage （P〈0.05）. The incidence rate of biliary infection and pancreatitis were superoir to those in retrograde biliary drainage group （P〈0.05）. Conclusion Anterograde biliary drainage has the advantages of quick recovery and less complication compared to retrograde biliary drainage. Anterograde biliary drainage is the best choose of palliative biliary drainage given to the patients suffer from advanced hilar cholangiocarcinoma.