超声内镜引导下置入覆膜金属支架治疗恶性梗阻性黄疸  

EUS-guided biliary drainage using a fully covered self-expandable metal stent for malignant obstructive jaundice

作　　者：黄平[1] 张筱凤 吕文[1] 范震 蒋楠[1] 王霞 梁三红[1] Huang Ping;Zhang Xiaofeng;Lyu Wen;Fan Zhen;Jiang Nan;Wang Xia;Liang Sanhong(Department of Gastroenterology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China)

机构地区：[1]浙江大学医学院附属杭州市第一人民医院消化内科,杭州310006

出　　处：《中华肝胆外科杂志》2019年第3期189-193,共5页Chinese Journal of Hepatobiliary Surgery

基　　金：杭州市科技发展计划项目(20140733Q11).

摘　　要：目的探讨超声内镜(EUS)引导下全覆膜自膨式金属支架治疗恶性梗阻性黄疸的疗效。方法对2016年1月2018年1月在浙江大学医学院附属杭州市第一人民医院行ERCP失败的恶性梗阻性黄疸患者行EUS放置全覆膜自膨式金属支架,观察患者的操作成功率、肝功能指标恢复情况、并发症发生率、住院时间和生存期。结果36例患者中34例操作成功,成功率为94.4%(34/36)。其中经胃穿刺者19例,经十二指肠穿刺15例。患者术后肝功能恢复时间为(25.8±6.5)d。患者并发胆道出血及胆管炎各1例,经保守治疗后改善,并发症发生率5.6%(2/36);住院时间(21.5±4.7)d,生存期(220.5±54.8)d。结论EUS下置入全覆膜自膨式金属支架可作为恶性梗阻性黄疸患者一个可行、有效的姑息治疗方案。Objective To study the therapeutic effects of EUS-guided biliary drainage (EUS-BD) using a nitinol fully covered self-expandable metal stents in patients with malignant obstructive jaundice after failed ERCP. Methods From January 2016 to January 2018, all patients with malignant obstructive jaundice who failed ERCP underwent EUS-guided biliary drainage using nitinol fully covered self-expandable metal stent at Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine. The operation success rate, liver functional recovery time, complication rate, length of hospital stay and survival time were observed. Results Of 36 patients who underwent EUS-guided biliary drainage, 34 were successfully performed, with 19 through the stomach, and 15 through the duodenum. The operation success rate was 94.4%(34/36). The liver functional recovery time of the 34 patients were 25.8 ± 6.5 days. One patient developed hemobilia and one cholangitis, both improved after conservative treatment. The total complication rate was 5.6%(2/36). The hospital stay and survival time were 21.5 ± 4.7 days and 220.5 ± 54.8 days, respectively. Conclusion EUS-BD using nitinol fully covered self-expandable metal stents was a feasible and effective treatment in patients with malignant biliary obstruction after failed ERCP.

关 键 词：黄疸 阻塞性 肿瘤 姑息疗法 超声内镜 胆道支架 胆道引流 

分 类 号：R730.5[医药卫生—肿瘤]