Analysis of the Application Effect of Tracheal Stent Placement in the Nutritional Support Treatment of Tracheoesophageal Fistula

Objective:To evaluate and analyze the application effect of tracheal stent placement in nutritional support therapy for tracheoesophageal fistula.Methods:Clinical data of 32 patients who underwent nutritional support therapy for tracheoesophageal fistula in our hospital from September 2021 to September 2022 were collected,and all patients underwent tracheal silicone stenting,comparing dyspnea classification and Karnofsky score before and after stenting,and conducting post-treatment follow-up.Results:In 32 patients with tracheoesophageal fistula,dyspnea grading improved from grades III and IV to grades 0 to II.Before treatment,10 patients(31.06%)were in grade IV,17 patients(53.12%)were in grade III,and five patients(15.62)were in grade II;after treatment,13 patients(40.63%)were in grade I,12 patients(37.50%)were in grade I,and seven patients(21.87%)were in grade 0(P<0.05);Karnofsky score(37.52±4.86 before treatment)improved significantly to 71.39±8.24 one week after treatment(P<0.05).Nine patients with tracheoesophageal fistula were placed with silicone Y14-10-10 stent,11 with silicone 18-14-14 stent,three with silicone Y15-12-12,and seven with silicone stent 16-13-13.Conclusion:Silicone tracheobronchial stent placement for the treatment of tracheoesophageal fistula is technically feasible,simple,and safe,with reliable near-term efficacy,and is worthy of popularization and application.

Different percutaneous transhepatic biliary stent placements and catheter drainage in the treatment of middle and low malignant biliary obstruction

BACKGROUND For cases of middle and low biliary obstruction with left and right hepatic duct dilatation,the type of approach and whether different approaches affect the difficulty of puncture operation and intraoperative and postoperative complications have not been discussed in detail.AIM To compare the efficacy of different percutaneous transhepatic biliary stent placements and catheter drainage in treating middle and low biliary obstruction.METHODS A retrospective analysis was performed on the medical records of 424 patients with middle and low biliary obstruction who underwent percutaneous liver puncture biliary stent placement and catheter drainage at the Department of Interventional Radiology,Shaanxi Provincial People’s Hospital between March 2016 and March 2022.Based on the puncture path,patients were categorized into two groups:Subxiphoid left hepatic lobe approach group(Group A,224 cases)and right intercostal,right hepatic lobe approach group(Group B,200 cases).Liver function improvement,postoperative biliary bleeding incidence,postoperative pain duration,and abdominal effusion leakage around the drainage tube were compared between the two groups at 3 d and 1 wk after the surgery.Patient survival time was recorded during follow-up.RESULTS All 424 surgeries were successful without adverse events.Group A comprised 224 cases,and Group B had 200 cases.There was no statistically significant difference in basic data between Group A and Group B(P>0.05).No significant difference in postoperative biliary bleeding incidence was observed between the groups(P>0.05).The decreased rates for total bilirubin(Group A:69.23±4.50,Group B:63.79±5.65),direct bilirubin(Group A:79.30±11.19,Group B:63.62±5.64),and alkaline phosphatase(Group A:60.51±12.23,Group B:42.68±23.56)in the 1st wk after surgery were significantly faster in Group A than in Group B.The decreased rate of gamma-glutamyl transpeptidase was also significantly faster in Group A at both 3 d(Group A:40.56±10.32,Group B:32.22±5.12)and 1 wk(Group A:73.19±7.05,Group B:58.81±18.98)after surgery(P<0.05).Group A experienced significantly less peritoneal effusion leakage around the drainage tube than Group B(P<0.05).The patient survival rate was higher in Group A compared to Group B(P<0.05).CONCLUSION In treating jaundice patients with middle and low biliary obstruction,a percutaneous left liver puncture demonstrated better clinical efficacy than a percutaneous right liver puncture.

Combined Use of Single-balloon Enteroscope and Colonoscope for Self-expandable Metal Stent Placement in Patients with Malignant Small Intestinal Obstruction: a Single-center Comparative Clinical Observation

Small intestinal obstruction is a common complication of primary gastrointestinal cancer or metastatic cancers. Patients with this condition are often poor candidates for surgical bypasses, and placement of self-expanding metal stent(SEMS) can be technically challenging. In this study, we examined the feasibility of combined application of single-balloon enteroscope(SBE) and colonoscope for SEMS placement in patients with malignant small intestinal obstruction. Thirty-four patients were enrolled in this study, among which 22 patients received SEMS placement by using SBE and colonoscope, while the other 12 patients received conservative medical treatment. The patients were followed up for one year. Stent placement was technically feasible in 95.5%(21/22). Clinical improvement was achieved in 86.4%(19/22). For the 19 clinical success cases, the average time of benefits from a gastric outlet obstruction scoring system(GOOSS) increase ≥1 was 111.9±89.5 days. For the 12 patients receiving conservative medical treatment, no significant improvement in GOOSS score was observed. Moreover, a significant increase of Short-Form-36 health survey score was observed in the 19 patients at time of 30 days after stent placement. By Kaplan-Meier analysis, a significant survival improvement was observed in patients with successful SEMS placement, compared with patients receiving conservative medical treatment. Taken together, combined use of SBE and colonoscope makes endoscopic stent placement feasible in patients with malignant small intestinal obstruction, and patients can benefit from it in terms of prolonged survival and improved quality of life.

Current Status and Prospect of Stent Placement for May-Thurner Syndrome

Stent implantation has been proven to be safe and has become the first-line intervention for May-Thumer syndrome(MTS),with satisfactory mid-term patency rates and clinical outcomes.Recent research has demonstrated that catheter-directed thrombolysis is the preferred strategy when MTS is combined with deep vein thrombosis after self-expanding stent placement.However,the stent used for the venous system was developed based on the experience obtained in the treatment of arterial disease.Consequently,relatively common corresponding complications may come along later,which include stent displacement,deformation,and obstruction.Different measures such as adopting a stent with a larger diameter,improving stent flexibility,and increasing stent strength have been employed in order to prevent these complications.The ideal venous stent is presently being evaluated and will be introduced in detail in this review.

Predictive factors for the failure of endoscopic stent-instent self-expandable metallic stent placement to treat malignant hilar biliary obstruction

AIM To investigate the factors predictive of failure when placing a second biliary self-expandable metallic stents(SEMSs). METHODS This study evaluated 65 patients with an unresectable malignant hilar biliary obstruction who were examined in our hospital. Sixty-two of these patients were recruited to the study and divided into two groups: the success group, which consisted of patients in whom a stent-in-stent SEMS had been placed successfully, and the failure group, which consisted of patients in whom the stent-in-stent SEMS had not been placed successfully. We compared the characteristics of the patients, the stricture state of their biliary ducts, and the implemented endoscopic retrograde cholangiopancreatography(ERCP) procedures between the two groups.RESULTS The angle between the target biliary duct stricture and the first implanted SEMS was significantly larger in the failure group than in the success group. There were significantly fewer wire or dilation devices(ERCP catheter, dilator, or balloon catheter) passing the first SEMS cell in the failure group than in the success group. The cut-off value of the angle predicting stent-in-stent SEMS placement failure was 49.7 degrees according to the ROC curve(sensitivity 91.7%, specificity 61.2%). Furthermore, the angle was significantly smaller in patients with wire or dilation devices passing the first SEMS cell than in patients without wire or dilation devices passing the first SEMS cell. CONCLUSION A large angle was identified as a predictive factor for failure of stent-in-stent SEMS placement.

Endoscopic transcystic stent placement for an intrahepatic abscess due to gallbladder perforation

Perforation of the gallbladder with cholecystohepatic communication is a rare cause of liver abscess. Because it is a rare entity, the treatment modality has not been fully established. We report for the first time a patient with an intrahepatic abscess due to gallbladder perforation successfully treated by endoscopic stent placement into the gallbladder who had a poor response to continuous percutaneous drainage.

Clinical Comparison of Airway Stent Placement in Intervention Room and Operating Room

Background and objective Airway stent placement is the effective regimen for central airway obstruction(CAO),while its application scenarios varied.This study aimed to make clinical comparison of airway stent placement in the intervention room and operating room.Methods Patients underwent airway stent placement between 2014 and 2018 were included in this retrospective case-control study.Clinical performance of airway stent placement in intervention room and operating room were compared.Results 82 patients were included in this study,including 39 in the intervention room and 43 in the operating room.Patients treated in the intervention room had lower Charlson comorbidity index(CCI)(P=0.018)and received less Y-shaped stents(P<0.001).Better clinical response(P=0.026),more stents placed(P<0.001)and longer length of stent(P<0.001)were observed in operating room,while there was no significantly statistical difference of stent-related complications and post-stent survival rate between the two groups.Extracorporeal membrane oxygenation(ECMO)supported airway stent placement procedures were performed in the operating room,which provided definitive safety support for high-risk intervention.Conclusion Patients with CAO could benefit from the operating room scenario,and airway stent placement in the operating room is more suitable for patients with higher CCI scores and receiving more complicated procedures.

Malignant obstruction in the ileocecal region treated by selfexpandable stent placement under the fluoroscopic guidance: A case report

BACKGROUND Malignant tumors of the ileocecal region often cause intestinal obstruction.Emergency surgery is the main treatment for patients presenting with an obstruction.However,this procedure is associated with a high mortality rate and frequent complications.The placement of colon stents is commonly performed for obstructions in the distal colon and is a less invasive and safer procedure.However,obstructions in the proximal colon are more challenging to treat by stent placement due to the increased distance from the anus.CASE SUMMARY This case report concerns an 88-year-old man with malignant intestinal obstruction in the ileocecal region.He was contraindicated for general anesthesia and surgical enterostomy.The placement of a self-expandable metallic stent seems an alternative to surgery,although stenting in this area is thought to be difficult and few studies have been reported so far.After three attempts at different interventional approaches,a stent was successfully placed in the obstructed segment under fluoroscopic guidance.After the procedure,the patient's abdominal distension and abdominal pain were significantly better than before.CONCLUSION For patients with proximal colonic obstruction,self-expandable metallic stent placement under fluoroscopic guidance could be considered as a feasible treatment to relieve abdominal distension and pain in patients with acute bowel obstruction.It has the characteristics of high safety and high patient tolerance.However,further study is still needed.

Does delaying ureteral stent placement lead to higher rates of preoperative acute pyelonephritis during pregnancy?

BACKGROUND Pregnancy with renal colic may cause pyelonephritis,decreased renal function,systemic infection and even shock in pregnant women,and cause premature birth and other adverse pregnancy outcomes.When surgery is necessary,the relationship between timing of the operation and the outcome of the mother and child are not known.AIM To investigate the association between time to ureteral stent placement and clinical outcomes of patients with renal colic during pregnancy.METHODS In this retrospective study,pregnant women with renal colic who underwent surgery were studied.Maternal preoperative acute pyelonephritis(PANP),pregnancy outcome,and length of hospital stay(LOS)were compared between the two groups.RESULTS 100 patients were included in the analysis,median age was 30 years.Median time to ureteral stent placement was 48 h(interquartile range,25-96 h),and 32 patients(32%)were diagnosed with PANP.PANP was closely related to hospitalization costs,re-admission to the hospital due to urinary tract infection after surgery and premature delivery.Multivariate analysis found that stone location and time from pain to admission were related to PANP.CONCLUSION Both early and delayed surgery are safe and effective for the treatment of renal colic during pregnancy.Early surgery may be superior to a delayed procedure due to shorter LOS.For pregnant patients with renal colic,delayed surgery within 48 h is not related to the clinical outcome of the mother and child.However,the time from pain to hospital admission was related to PANP.

Vascular morphological change due to endovascular stent placement for intracranial aneurysm

Objective The purpose of this study was to quantify the vascular angle change due to intracranial stent placement and its effect on hemodynamics. Methods Fifteen patients with a wide-necked anterior communicating artery aneurysm were treated with stent-assisted coiling. Centerlines of the parent vessels were calculated and determined the exact change in

Effect of polyglycolic acid sheet plus esophageal stent placement in preventing esophageal stricture after endoscopic submucosal dissection in patients with earlystage esophageal cancer: A randomized, controlled trial

AIM To assess the effect of polyglycolic acid(PGA) plus stent placement compared with stent placement alone in the prevention of post-endoscopic submucosal dissection(ESD) esophageal stricture in early-stage esophageal cancer(EC) patients. METHODS Seventy EC patients undergoing ESD were enrolled in this randomized, controlled study. Patients were allocated randomly at a 1:1 ratio into two groups as follows:(1) PGA plus stent group(PGA sheet-coated stent placement was performed); and(2) Stent group(only stent placement was performed). This study was registered on http://www.chictr.org.cn(No. chictrinr-16008709). RESULTS The occurrence rate of esophageal stricture in the PGA plus stent group was 20.5%(n = 7), which was lower than that in the stent group(46.9%, n = 15)(P = 0.024). The mean value of esophageal stricture time was 59.6 ± 16.1 d and 70.7 ± 28.6 d in the PGA plus stent group and stent group(P = 0.174), respectively. Times of balloon dilatation in the PGA plus stent group were less than those in the stent group [4(2-5) vs 6(1-14), P = 0.007]. The length(P = 0.080) and diameter(P = 0.061) of esophageal strictures were numerically decreased in the PGA plus stent group, whereas no difference in location(P = 0.232) between the two groups was found. Multivariate logistic analysis suggested that PGA plus stent placement(P = 0.026) was an independent predictive factor for a lower risk of esophageal stricture, while location in the middle third(P = 0.034) and circumferential range = 1/1(P = 0.028) could independently predict a higher risk of esophageal stricture in EC patients after ESD. CONCLUSION PGA plus stent placement is more effective in preventing post-ESD esophageal stricture compared with stent placement alone in EC patients with earlystage disease.

Updated meta-analysis of pancreatic stent placement in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis

AIM: To investigate the efficacy and safety profile ofpancreatic duct(PD) stent placement for prevention of post-endoscopic retrograde cholangiopancreatography(ERCP) pancreatitis(PEP). METHODS: We performed a search of MEDLINE, EMBASE, and Cochrane Library to identify randomized controlled clinical trials of prophylactic PD stent placement after ERCP. Rev Man 5 software provided by Cochrane was used for the heterogeneity and efficacy analyses, and a meta-analysis was performed for the data that showed homogeneity. Categorical data are presented as relative risks and 95% confidence intervals(CIs), and measurement data are presented as weighted mean differences and 95%CIs. RESULTS: The incidence rates of severe pancreatitis, operation failure, complications and patient pain severity were analyzed. Data on pancreatitis incidence were reported in 14 of 15 trials. There was no significant heterogeneity between the trials(I2 = 0%, P = 0.93). In the stent group, 49 of the 1233 patients suffered from PEP, compared to 133 of the 1277 patients in the no-stent group. The results of this meta-analysis indicate that it may be possible to prevent PEP by placing a PD stent. CONCLUSION: PD stent placement can reduce postoperative hyperamylasemia and might be an effective and safe option to prevent PEP if the operation indications are well controlled.

Inferior pancreaticoduodenal artery aneurysm treated with coil packing and stent placement

Two cases with a pancreaticoduodenal arterial aneurysm accompanied with superior mesenteric artery(SMA) stenosis were previously described and both were treated surgically.However,for interventional treatment,securing a sufficient blood supply to the SMA should be a priority of treatment.We present the case of a 71-year-old male with a 20 mm diameter pancreaticoduodenal arterial aneurysm accompanied by SMA stenosis at its origin.The guidewire traverse from SMA to the aneurysm was difficult because of the tight SMA stenosis;however,the guidewire traverse from the celiac artery was finally successful and was followed by balloon angioplasty using a pull-through technique,leading to stent placement.Thereafter,coil packing through the SMA achieved eradication of the aneurysm without bowel ischemia.At the last follow-up computed tomography 8 mo later,no recurrence of the aneurysm was confirmed.The pull-through technique was useful for angioplasty for tight SMA stenosis in this case.

Clinical application of trans-sinus gastric stent placement and drainage in the management of persistent external pancreatic fistula after minimal access retroperitoneal pancreatic necrosectomy in severe acute pancreatitis patients

Background:Persistent external pancreatic fistula(EPF)in patients with pancreatic duct disruption or disconnection can result from minimal access to retroperitoneal pancreatic necrosectomy(MARPN)in severe acute pancreatitis patients,which is a difficult problem for clinicians and requires a long treatment duration.This study aimed to investigate the effectiveness and safety of trans-sinus gastric stent placement and drainage using interventional technology in the management of persistent EPF after MARPN in severe acute pancreatitis.Methods:From August 2018 to December 2020,the data of 9 patients with persistent EPF treated with trans-sinus gastric stent placement and drainage in our hospital were retrospectively collected.The main outcome measures were technical success rate,recurrence rate,new pancreatic fluid collection,morbidity,and mortality.All patients were followed up after the procedure through clinic visits and imaging modalities.Results:The median age of the patients was 46 years(30-61 years).The median persistent EPF duration was 5 months(2-12 months).The median follow-up time was 41 months(range,20-47 months).The median operation time was 48 minutes(range,40-54 minutes),and the technical success rate was 100%.Seven days after treatment,the percutaneous drainage tubes of all patients were removed.Six months after the procedure,2 patients lost the stents,and one of those patients suffered from a pseudocyst,which gradually increased to a maximum diameter of 7 cm over 9 months.Therefore,a double pigtail drainage tube was placed under the guidance of an endoscope.The second of these 2 patients had no recurrence or pseudocyst.Twelve months after the procedure,another 3 patients lost the stents;18 months after the procedure,another 2 patients lost the stents.These patients had no recurrence as well.No other adverse events or deaths occurred during the study period.Conclusion:Trans-sinus tract gastric stent placement and drainage are safe and effective in the treatment of persistent EPF after MARPN in severe acute pancreatitis patients.However,this study had a small sample size and did not include a comparative group.

Case of Fatal Air Embolism during Double‑J Ureteral Stent Placement

Air embolism is a severe and fatal complication,but it is very rare during transurethral surgery.This report describes a case of air embolism during double‑J ureteral stent placement in a 45‑year‑old woman.During ureteroscopy,a sudden decrease in oxygen saturation and end‑expiratory carbon dioxide pressure and cyanosis of the face were observed.Subsequent echocardiography confirmed an air embolism by detecting bubbles in the heart.Despite resuscitative measures,the patient died rapidly.Detailed autopsy was performed to clarify the cause of death and the route of air entering into the circulatory system.The report presented here reminds urologists and pathologists that air embolism can occur during double‑J ureteral stent placement and offers some suggestions regarding identification of air embolism at autopsy.

Stent type used does not impact complication rate or placement time but can decrease treatment cost for benign and malignant esophageal lesions

AIM: To evaluate if differences exist between selfexpanding esophageal metal stents(SEMS) and selfexpanding esophageal plastic stents(SEPS) when used for benign or malignant esophageal disorders with regard to safety, efficacy, clinical outcomes, placement ease and cost.METHODS: A retrospective analysis was performed to evaluate outcome in patients having SEPS/SEMS placed for malignant or benign esophageal conditions from January 2005 to April 2012. Inclusion criteria was completed SEMS/SEPS placement. Outcomes assessed included technical success of and time required for stent placement, procedure-related complications, need for repeat intervention, hospital stay, mortality and costs.RESULTS: Forty-three patients underwent stent placement for either benign/malignant esophagealdisease during the study period. Thirty patients had SEMS(25 male, mean age 59.6 years old) and 13 patients had SEPS(10 male, mean age 61.7 years old). Placement outcome as well as complication rate(SEPS 23.1%, SEMS 25.2%) and in-hospital mortality(SEPS 7.7%, SEMS 6.7%) after placement did not differ between stent types. Migration was the most frequent complication reported occurring equally between types(SEPS 66.7%, SEMS 57.1%). SEPS was less costly than SEMS, decreasing institutional cost by $255/stent.CONCLUSION: SEPS and SEMS have similar outcomes when used for benign or malignant esophageal conditions. However, SEPS use results in decreased costs without impacting care.

腔内介入结合硅酮支架置入术治疗Ⅳ、Ⅴ型气管支气管结核的临床研究

目的:研究腔内介入结合硅酮支架置入术治疗Ⅳ、Ⅴ型气管支气管结核(TBTB)的临床效果。方法:选择2019年1月—2023年12月于江西省胸科医院治疗的20例Ⅳ、Ⅴ型TBTB患者。所有患者均采用腔内介入结合硅酮支架置入术治疗。观察治疗前后的临床疗效、呼吸困难程度、肺功能指标、血气分析指标、管腔直径变化及并发症发生情况。结果:20例Ⅳ、Ⅴ型TBTB患者治疗后的总有效率为95.00%(19/20)。治疗后,患者的改良英国医学研究委员会呼吸困难量表(mMRC)评分、二氧化碳分压(PaCO_(2))均低于治疗前,第1秒用力呼气容积(FEV1)、动脉血氧分压(PaO_(2))及管腔直径均高于治疗前,差异均有统计学意义(P<0.05)。20例Ⅳ、Ⅴ型TBTB患者治疗后并发症总发生率为10.00%(2/20)。结论:腔内介入结合硅酮支架置入术治疗Ⅳ、Ⅴ型TBTB效果确切,能够减轻患者呼吸困难程度,改善患者血气指标及肺功能,扩大管腔直径,且并发症发生率低。

脑CT灌注成像在脑动脉狭窄介入术后脑过度灌注综合征的应用

目的:探讨脑CT灌注成像(cerebral CT perfusion imaging,CTP)检查用于颅内外动脉狭窄(intracranial and extracranial arterial stenosis,ICAS)的诊断应用及预测支架成形术后发生脑过度灌注综合征(cerebral hyperperfusion syndrome,CHS)的预测价值。方法:收集分析南阳市中心医院2020年12月至2021年12月,100例经支架置入术前检查确诊为颅内外动脉狭窄的患者,同时所有患者术前均接受CTP检查。分析支架置入术后发生CHS与非CHS患者的术前CTP的CTP参数,对患者术后发生CHS的预测价值。结果:CTP检查显示低灌注颅内外动脉狭窄患者患侧局部脑血容量(regional cerebral blood flow,rCBF)较健侧降低,患侧脑血流体积(regional cerebral blood volume,rCBV)较健侧增加,局部平均通过时间(regional mean transit time,rMTT)、局部达峰时间(regional time to peak,r TTP)较健侧延长,差异有统计学意义(P <0.05);发生CHS的患者的术前rTTP、rMTT较非CHS组患者延长,差异有统计学意义(P <0.05);术前CTP参数rMTT、rTTP对患者支架置入术后发生CHS具有预测价值。结论:CTP可以作为一种很有前途的临床诊断工具来诊断颅内外狭窄的患者,能反应血流动力学变化。rMTTP、rTTP对支架成形术后是否发生CHS有一定的预测。

DSA联合3D ASL对优势侧椎动脉狭窄支架置入前后小脑半球血流动力学改变的评估

目的:探讨DSA联合3D动脉自旋标记技术(ASL)在椎动脉狭窄支架置入前后小脑半球血流动力学评估中的应用价值。方法:回顾性分析21例因优势侧椎动脉颅外段管腔狭窄行支架置入术患者的临床、DSA及ASL资料,评估不同标记后延迟时间(PLD)、椎动脉优势侧与非优势侧、支架置入术前后小脑半球不同供血区脑灌注的变化。结果:21例术前DSA显示优势侧椎动脉重度狭窄,支架置入部位均为优势侧椎动脉颅外段,术后狭窄均解除。PLD为2.5 s时,术前、术后,优势侧及非优势侧,小脑各供血区脑血流量(CBF)值均较PLD为1.5 s时高,差异均有统计学意义(均P<0.05)。术后在椎动脉优势侧,小脑上动脉供血区、小脑前下动脉供血区、小脑后下动脉供血区的CBF值均高于术前(包括PLD=1.5、2.5 s);椎动脉非优势侧,小脑上动脉供血区的CBF值高于术前(包括PLD=1.5、2.5 s)。结论:DSA联合ASL能定量评估小脑半球的血流动力学改变,优势侧椎动脉狭窄支架置入术能提高椎动脉优势侧小脑半球各区的脑血流灌注水平及椎动脉非优势侧的小脑半球小脑上动脉供血区的脑血流灌注水平。

经内镜逆行胰胆管造影胆管支架置入术对老年恶性梗阻性黄疸患者免疫炎性反应及肝功能的影响

目的探讨经内镜逆行胰胆管造影(ERCP)胆管支架置入术治疗老年恶心梗阻性黄疸(MOJ)患者临床疗效及可能作用机制。方法收集2020年7月至2022年6月在我院接受胆管支架置入术治疗的老年MOJ患者102例临床资料,根据胆管支架置入方式分为ERCP组(54例)与PTCD组(48例),比较两组手术成功率与临床疗效、细胞免疫功能、炎性因子、肝功能、不良反应等指标。结果ERCP组低位梗阻患者手术成功率、临床疗效高于PTCD组(χ^(2)=4.193,4.877,P<0.05);CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于PTCD组,CD8^(+)低于PTCD组(P<0.05);血清C-反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)低于PTCD组(P<0.05);血清谷草转氨酶(AST)、谷丙转氨酶(ALT)、总胆红素(TBil)、直接胆红素(DBil)低于PTCD组(P<0.05);导管堵塞等并发症7.41%低于PTCD组22.92%(χ^(2)=4.873,P<0.05)。结论ERCP胆管支架置入能够提高手术治疗效果,减少并发症的发生,可能与调节细胞免疫功能、抑制炎症反应、改善肝功能等因素有关。