经内镜内外引流治疗不同部位胆道梗阻方法探讨(附104例报告)

Endoscopic internal or external biliary drainage for various biliary obstructions:Report of 104 cases

目的 探讨内镜诊治不同病变、不同部位胆道梗阻的价值。 方法 回顾分析 1998年 10月～ 2 0 0 2年 11月 10 4例胆道梗阻施行十二指肠镜下各种胆道引流术的临床资料。 结果 97例引流成功 ,成功率 93 3% (97/ 10 4 ) ,胆道梗阻症状得到缓解 (腹痛缓解、黄疽减退、体温下降 ) ,ENBD、ERBD疗效满意率分别为 93 0 % (6 6 / 71)和 93 3% (2 8/ 30 )。 结论经内镜引流治疗胆道梗阻 ,具有创伤小、痛苦少、恢复快、住院时间短及疗效确切等优点 ,注意引流部位和方法的选择 ,可进一步提高经内镜胆道引流术的成功率。

Objective To investigate the value of endoscopy in the diagnosis and treatment of biliary obstructions on different sites with variable causes. Methods The clinical records of biliary drainages under duodenoscope in 104 patients with biliary obstruction from October 1998 to November 2002 was reviewed retrospectively. Results Drainage was successfully completed in 97 patients, with a success rate of 93.3%(97/104). The patients were relieved of their symptoms of biliary obstruction (abdominal pain, jaundice and fever), and the effective rates of ENBD and ERBD were 93.0% (66/71) and 93.3% (28/30), respectively. Conclusions Endoscopic drainage for biliary obstruction has advantages of minimal invasion, rapid recovery, short hospital stay and apparent efficacy. Emphasis should be placed on the site of drainage and proper selection of operative method to further elevate its success rate.