经皮肝胆管穿刺金属内支架植入治疗恶性梗阻性黄疸(附32例报告)  

Percutaneous placement of biliary metallic stent for treatment of malignant obstructive jaundice

作　　者：吕定量[1] 武金才[1] 江朝根[1] 罗祖贤[2] 

机构地区：[1]浙江省衢州市人民医院外科,324000 [2]浙江省人民医院外科

出　　处：《临床外科杂志》2005年第7期416-417,共2页Journal of Clinical Surgery

摘　　要：目的探讨经皮肝胆管穿刺金属内支架植入治疗恶性梗阻性黄疸临床应用价值。方法2000年10月～2004年10月,对32例恶性梗阻性黄疸患者施行经皮肝胆管穿刺金属内支架植入。其中胆管癌17例,胰腺癌5例,肝门部转移癌10例。梗阻部位:肝总管肝门区20例,胆总管12例。结果金属内支架植入成功率100%(32/32)。2例出现胆汁性腹膜炎,胆道出血1例。28例术后血清胆红素3～4周降至正常,黄疸完全消失率87.5%(28/32)。生存期3～18个月,平均8个月。3例分别于术后6、8、13个月出现梗阻性黄疸,再梗阻发生率9%(3/32)。结论经皮肝胆管穿刺金属内支架植入是治疗恶性梗阻性黄疸安全、有效的姑息性治疗方法。Objective To evaluate the clinical application of percutaneous placement of biliary stent for treatment of malignant obstructive jaundice.Methods Biliary metallic stent was percutaneously inserted in 32 patients with malignant obstructive jaundice from Oct.2000 to Oct.2004.There were 17 cases of cholangiocarcinoma,5 cases of pancreatocarcinoma,10 cases of hepatic hiliar metatic carcinoma.The biliary obstruction was located in the common bile duct,the common hepatic duct in 12 and 20 patients respectively.Results The technical successful rate was 100%.Two cases had infection and one case had bleeding after release of the stent.The serum bilirubim level was remarkably declined to normal in 3～4 weeks in 28 cases.The jaundice disappearing rate was 87.5%.The survival time was 13-18 months(mean 8 months).Obstructive jaundice reappeared after release of the stent in 6.8 and 13 months in 3 patients.Jaundice recurrent rate was 9%.Conclusion Treating obstructive jaundice with a metallic is a relatively simple and effective method in the management of malignant obstructive jaundice.

关 键 词：穿刺 内支架 恶性梗阻性黄疸 

分 类 号：R735[医药卫生—肿瘤]