内镜下置人胆管支架治疗恶性胆道梗阻的临床应用  

Clinical application of endoscopic biliary endoprosthesis for treatment of maglinant biliary obstruction

作　　者：庄伟[1] 李玉梅[1] 周美树[1] 蔡伟祥[1] 

机构地区：[1]武警浙江总队医院消化内科,嘉兴314000

出　　处：《武警医学》2009年第9期788-790,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨内镜下胆管支架置入术治疗恶性胆道梗阻的疗效及应用价值。方法全部病例经内镜逆行胰胆管造影术(ERCP)确定胆管狭窄部位及程度,选择合适的支架,在透视引导下置入支架。塑料支架组16例,金属支架组12例。观察其操作成功率、黄疸消退效果、并发症发生情况及6～12个月生存率。结果首次置管成功率83.3%,总置管成功率93.3%,置管成功28例均达到降黄疸目的,临床症状缓解。早期并发症主要为ERCP术后胰腺炎及胆管炎,其中胰腺炎2例,发生率7.1%;胆管炎3例,发生率10.7%;晚期并发症主要为支架堵塞。6个月、12个月生存率分别达78.6%及39.3%。结论内镜下胆管支架置入术治疗恶性胆道梗阻是安全有效的方法。Objective To evaluate endoscopic biliary stent placement in treating malignant biliary obstruction. Methods The biliary obstruction in all the patients was diagnosed through endoscopic retrograde cholangiopancreatography （ ERCP）, and the stent was inserted under fluoroscopic guidance into the right site from oral cavity. Sixteen patients received plastic stems included, and t2 receiued Mental stents. The success rate of insertion, palliative level of jaundice, rate of complication, and 6 and 12 month survival rate were observed. Results The successful rate of stents placement was 83.3% in the first time and the total successful rate was 93.3%. The purpose of the treatment to relieve jaundice was fulfilled in 28 cases with successful stent insertion, and their clinical symptoms were mitigated. The early complications included ERCP - associated pancreatitis （2 cases, 7.1% ） and cholangitis （3 eases, 10.7% ）, and obstruction of stent was the major late complication. The 6 and 12 month survival rates were 78.6% and 39.3%, respectively. Conclusions Endoscopic biliary stent placement is a safe and effective method in treating maglinant biliary obstruction.

关 键 词：恶性胆道梗阻 内镜 胆管支架 

分 类 号：R735.8[医药卫生—肿瘤]