肝门部胆管癌Bismuth分型与经内镜胆道塑料支架引流术后并发症及退黄效果之间的关系  

Relationship of hilar cholangiocarcinoma Bismuth type with incidence of complications of endoscopic retrograde cholangiopancreatography andjaundice clearance

作　　者：章诺贝[1] 黄年根[1] 

机构地区：[1]南昌大学第二附属医院消化科,江西省南昌市330006

出　　处：《世界华人消化杂志》2011年第5期529-532,共4页World Chinese Journal of Digestology

摘　　要：目的:评估肝门部胆管癌Bismuth分型与经内镜胆道塑料支架引流术(ERBD)术后并发症及退黄效果之间的关系.方法:收集已确诊为肝门部胆管癌、且不能或不愿接受外科治疗的,在南昌大学第二附属医院消化科行ERBD的患者.分析各型肝门部胆管癌之间在行ERBD术后胆管炎、胰腺炎、出血发生率以及退黄效果的差异.结果:Bismuth Ⅲ型和Ⅳ型肝门部胆管癌ERBD术后胆管炎发生率显著高于Bismuth Ⅰ型和Ⅱ型(59.52%vs3.33%;59.52%vs4.00%,均P<0.01),而退黄有效率相对较低(71.43%vs96.67%;71.43%vs100.00%,均P<0.01);术后胰腺炎和出血的发生率在各型中无显著性差异(均P>0.05).结论:肝门部胆管癌Bismuth Ⅲ型和Ⅳ型在ERBD术后更易并发胆管炎,且术后退黄效果不够理想.AIM：To evaluate the relationship of hilar cholangiocarcinoma Bismuth type with incidence of complications of endoscopic retrograde cholangiopancreatography（ERBD） and jaundice clearance.METHODS：Ninety-seven patients with inoperable hilar cholangiocarcinoma were treated by ERBD.The differences in the incidence of cholangitis,pancreatitis,bleeding,and the rate of jaundice clearance were compared among different types of hilar cholangiocarcinoma.RESULTS：Patients with Bismuth types III and IV hilar cholangiocarcinoma had a significantly higher incidence of post-ERBD cholangitis（59.52% vs 3.33%;59.52% vs 4.00%,both P 0.01） and a lower rate of jaundice clearance（71.43% vs 96.67%;71.43% vs 100.00%,both P 0.01） than those with Bismuth types Ⅰ and Ⅱ disease.However,there were no significant differences in the incidences of post-ERBD pancreatitis and bleeding among all types of hilar cholangiocarcinoma（P 0.05）.CONCLUSION：Bismuth types Ⅲ and IV hilar cholangiocarcinoma is associated with a significantly higher risk of post-ERBD cholangitis and a lower rate of jaundice clearance.

关 键 词：肝门部胆管癌 BISMUTH分型 经内镜胆道塑料支架引流术 并发症 退黄 

分 类 号：R735.8[医药卫生—肿瘤]