经皮胆道金属支架植入治疗恶性梗阻性黄疸术后支架再狭窄的研究进展

Postoperative stent restenosis of percutaneous biliary metal stent implantation for malignant obstructive jaundice:recent progress in clinical research

恶性梗阻性黄疸是由恶性肿瘤导致胆道梗阻,经皮肝胆道内金属支架植入术已成为解除恶性梗阻性黄疸的主要措施之一。但术后并发症严重影响患者的生活质量及生存期,其中支架再狭窄严重影响着患者预后,因此术后积极预防和正确处理支架再狭窄对于经皮肝胆道内金属支架植入术显得尤为重要。引起支架再狭窄的原因包括肿瘤生长、胆汁淤积和肉芽组织增生,目前主要治疗措施分为再次植入支架、改造支架结构和联合治疗。本文针对术后支架再狭窄的起因及预防进行综述。

Malignant obstructive jaundice is caused by biliary obstruction due to malignant tumor, and in clinical practice percutaneous transhepatic biliary metal stent implantation has already become one of the main measures to relieve malignant obstructive jaundice. Nevertheless, postoperative complications severely affect the life quality and survival of patients, especially the stent restenosis seriously influences the patient＇s prognosis, therefore, after percutaneous transhepatic biliary metal stent implantation the use of active preventive measures and the correct treatment of stent restenosis are particularly important. The causes of stent restenosis include tumor growth, cholestasis and proliferation of granulation tissue, and the main measures to prevent stent restenosis at present are re-implantation of the stent, reformation of the stent structure and combination therapy. This article aims to make a comprehensive reviewabout the causes of postoperative stent restenosis and the effective preventive measures.