超声引导胆道内支架植入术治疗胆道狭窄

Treatment of biliary stricture by percutaneous transhepatic insertion of metallic stent under the ultrason

目的 :采用超声引导下经皮穿肝胆道内支架植入术治疗梗阻性黄疸并探讨其疗效和技术要点。方法 :3 5例胆道狭窄接受经皮经肝胆道内支架置入术 ,其中胆管癌 18例 ,胰头癌 8例 ,肝门区转移癌 4例 ,和胆道术后狭窄 5例。结果 :支架释放技术成功率为 97 1%。 3例患者行左、右肝管双支架置入。近期 90 %以上患者总胆红素下降 >5 0 %。恶性梗阻 1年生存率达 65 7%。无严重并发症出现。结论 :超声导引下经皮穿肝胆道内支架植入术治疗胆管狭窄安全有效且操作简便 ,技术成功率高 ,可提高恶性梗阻患者的生存率。

Objective:To investigate the therapeutic effect and technique of treatment of biliary stricture by percutaneous transhepatic insertion of biliary stent(PTIBS)under the ultrason.Methods:35 patients with biliary stricture were treated by PTIBS,including hilar biliary cancer 18 cases,pancreatic cancer 8 cases,hilar metastatic cancer 4 cases,and post operative biliary stricture of bile duct 5 cases.Results:The technical success rate was 97 1%.Two stents were placed in the right and left heptic ducts respectively in 3 cases.Total bilirubin was descented a half in 90% patients in the near future.The survival rate of 12 monthes were 65 7%.No severe complications.Conclusion:PTIBS was a safe and effective method in the treatment of biliary stricture and there was a higher success rate of PTIBS.There for,the survival rate of malignant biliary stricture could be further improved.