经皮胆道内涵管置入术治疗恶性梗阻性黄疸的疗效分析

Therapeutic evaluation of percutaneous transhepatic plastic stent implantation for malignant obstructive jaundice

目的 探讨经皮经肝胆道内涵管置入术治疗恶性梗阻性黄疸的疗效及并发症。 方法 对 32例恶性梗阻性黄疸患者行经皮经肝胆道内涵管置入术 ,随访 35～ 376天 ,观察近中期疗效和并发症。 结果 经皮经肝胆道内涵管置入术技术成功率为 10 0 %。血清总胆红素水平于置入术后 1周较置入前明显下降 (P <0 .0 0 1) ,术后 2周较术后 1周明显下降 (P <0 .0 0 1)。开通时间平均为 10 1天 ,半年开通率为 5 0 %。并发症发生率 2 8 1% ,主要为胰腺炎和逆行胆道感染等。 结论 经皮经肝胆道内涵管置入术安全疗效可靠 。

Ojective To investigate the efficacy and complication of percutaneous transhepatic plastic stent implantation for maligant obstructive jaundice. Methods Percutaneous transhepatic plastic stent implantation was performed in 32 patients with malignant obstructive jaundice. The early and long term theraputic efficacy and complications of the technique in 32 patients were observed for follow-up periods of 35～376 days. Results Technical success rate was 100%. Serum total bilirubin decreased significantly the first week after percutaneous transhepatic plastic stent implantation ( t =3.643, P <0.001), while serum total bilirubin in the postoperative second week further decreased significatly as compared with that in the postoperative first week ( t =2.903, P <0.001). The mean patency time was 101 days and the ratio of half-year patency was 50.0%. The comlications occurred in 28.1% of patients, mainly including pancreatitis and retrograde biliary infection. Conclusions Percutaneous transhepatic plastic stent implantation is effective and safe and it can be used as a choice of interventional treatment of malignant biliary obstruction.