新型部分覆膜式分支一体化T/Y型支架治疗肝门部胆管恶性梗阻  

A new-type partially covered branch integration T/Y-shaped stent for malignant hepatic hilar biliary obstruction

作　　者：许凯豪 刘一铭 焦德超[1] 韩新巍[1] 王艳丽[1] 周朋利[1] 马波[1] 任克伟[1] XU Kaihao;LIU Yiming;JIAO Dechao;HAN Xinwei;WANG Yanli;ZHOU Pengli;MA Bo;REN Kewei(Department of Interventional Radiology,First Afiliated Hospital of Zhengzhou University,Zhengzhou,Henan Province 450052,China)

机构地区：[1]郑州大学第一附属医院放射介入科,河南郑州450052

出　　处：《介入放射学杂志》2023年第4期359-362,共4页Journal of Interventional Radiology

基　　金：河南省重大科技专项(221100310100)。

摘　　要：目的 评价新型部分覆膜式分支一体化T/Y型支架治疗肝门部胆管恶性梗阻的可行性和安全性。方法 纳入2018年10月至2019年10月接受新型部分覆膜式母子分支一体化T/Y型支架植入术治疗肝门部胆管恶性梗阻患者16例。记录技术成功率、临床成功率、并发症、6个月和12个月支架通畅率和总生存率,比较术前、术后1个月患者的血常规、肝功能、肾功能和CA199水平。结果 16例患者均获得技术成功和临床成功。早期并发症和晚期并发症分别为3例和2例,无大出血、重度感染、胆瘘、穿孔等严重并发症。平均随访时间358.9 d,6个月和12个月支架通畅率分别为66.7%和16.7%,总生存率分别为93.3%、75.0%。术后1个月ALT、AST、TBil、CA199水平较术前明显下降(P<0.01),而WBC、Hb、PLT、Cr、BUN较术前无明显变化(P>0.05)。结论 新型部分覆膜式分支一体化T/Y型支架治疗肝门部胆管恶性梗阻安全可行,有待进一步研究其远期疗效。Objective To evaluate the feasibility and safety of a new-type partially covered branch integration T/Y-shaped stent in treating malignant hepatic hilar biliary obstruction. Methods A total of 16patients with malignant hepatic hilar biliary obstruction(Bismuth type Ⅲ-Ⅳ), who received implantation of a new-type partially covered branch integration T/Y-shaped stent between October 2018 and October 2019,were enrolled in this study. The technical success rate, clinical success rate, complications, 6-month and 12-month stent patency rate, 6-month and 12-month overall survival rate were calculated. The levels of blood routine testing, liver functions, renal functions and CA199 at postoperative one-month were compared with the preoperative ones. Results Both the technical success and the clinical success were achieved in all the 16patients. Early complications and late complications were observed in 3 and 2 patients respectively. No serious complications such as massive haemorrhage, severe infection, biliary fistula or biliary perforation occurred.The mean follow-up time was 358.9 days. The 6-month and 12-month stent patency rates were 66.7% and 16.7%respectively, and the 6-month and 12-month overall survival rates were 93.3% and 75.0% respectively. The levels of ALT,AST,TBiL and CA199 at postoperative one-month were significantly decreased when compared with the preoperative ones(P<0.01), and levels of WBC, Hb, PLT, Cr and BUN were not obviously different from the preoperative values(P>0.05). Conclusion For the treatment of malignant hepatic hilar biliary obstruction,the implantation of a new-type partially covered branch integration T/Y-shaped stent is clinically safe and feasible, although its long-term efficacy needs to be further clarified.

关 键 词：梗阻性黄疸 胆管梗阻 T/Y型支架 

分 类 号：R735.7[医药卫生—肿瘤]