左右肝管横位支架在恶性高位复杂胆管梗阻治疗中的应用  

Application of transverse position stents between left and right hepatic duct in treatment for complex malignant upper biliary obstruction

作　　者：孙增涛[1] 薛福珍[2] 张垒[1] 陈颉[1] 

机构地区：[1]山东省医学影像学研究所介入科,济南250021 [2]山东省交通医院感染科

出　　处：《中华介入放射学电子杂志》2013年第2期40-43,共4页Chinese Journal of Interventional Radiology：electronic edition

摘　　要：目的探讨经右肝内胆管后下支置入左右肝管间横位支架在恶性高位复杂胆管梗阻治疗中的临床价值。方法 2007年1月—2011年9月,对17例恶性高位复杂胆管梗阻患者经右肝内胆管后下支途径置入左右肝管横位支架。患者中男性13例,女性4例;年龄62~83岁,平均（71±10.2）岁。结果 17例患者共计置入36枚金属支架和2条内外引流管。置入的17枚左右肝管横位支架中,释放后11例呈直管状（类＂=＂形状）,6例支架呈中段凹向头侧的弯管状（类＂︾＂形状）。患者均于支架置入术后7~15 d皮肤、巩膜黄染等症状明显改善,以及大、小便颜色恢复正常,之后出院或又实施经皮经肝粒子置入术及肝动脉化疗栓塞术治疗。术后3、6、12个月复诊或电话随访,生存患者分别为17、16、9例。结论左右肝管横位支架联合其他支架或引流管治疗恶性高位复杂胆管梗阻,使胆汁引流更充分,临床治疗效果好。Objective To explore the application of transverse position biliary stent between left and right hepatic duct in treating complex malignant upper biliary obstruction. Methods From January 2007 to September 2009, 17 patients underwent placement of left and right hepatic duct transverse position stents. There were 13 male and 4 female. The age ranged from 62 to 83 years old, average 71±10.2 years old. Results In 17 patients, a total of 36 metal bracket and the 2 internal and external drainage tubes were placed. In 17 transverse position biliary stents between left and right hepatic duct, 11 cases showed straight（＂=＂）, 6 cases showed ＂ ︾ ＂. The symptoms relieved in all these patients after 7-15 days. The survival number of the patients were 17, 16 and 9 respectively during the follow up time point of 3, 6 and 12 months postoperatively. Conclusions Transverse position confi guration stents into left and right hepatic duct combined with other support or a drainage tube in treatment of malignant biliary obstruction of high complexity, so that bile drainage more fully, clinical curative effect is good, cost reduction.

关 键 词：恶性胆管梗阻 经皮经肝胆管内支架置入术 管腔内支架 左肝管 右肝管 

分 类 号：R730.5[医药卫生—肿瘤]