经皮金属多支架置入治疗BismuthⅡ型及以上肝门部胆管癌的临床应用分析  

Clinical application of percutaneous multi-metal stent insertion for hilar cholangiocarcinoma with Bismuth-Corlette typeⅡor above

作　　者：许晨 俞靖凡 方昌文 张志轩[1] 徐国雄[1] 金一琦[1] Chen Xu;Jingfan Yu;Changwen Fang;Zhixuan Zhang;Guoxiong Xu;Yiqi Jin(Department of Vascular Surgery,Suzhou Municipal Hospital Affiliated to Nanjing Medical University,Jiangsu Suzhou 215008,China)

机构地区：[1]南京医科大学附属苏州医院血管介入科,江苏苏州215000

出　　处：《中华介入放射学电子杂志》2023年第2期123-127,共5页Chinese Journal of Interventional Radiology：electronic edition

摘　　要：目的应用经皮肝穿刺多支架置入术治疗BismuthⅡ型及以上肝门部胆管癌,评估该方法的有效性及安全性,分析支架通畅期及患者生存期。方法回顾性收集2019年1月至2021年9月,于南京医科大学附属苏州医院血管介入科收治并接受多支架置入的Ⅱ型及以上肝门部胆管癌患者的临床资料。分析手术技术成功率、临床成功率、肝功能变化、术后并发症、支架通畅期及患者生存期。结果共纳入108例患者,年龄38~92岁,平均(66.8±10.6)岁。手术技术成功率100%,临床成功率84.3%(91/108)。术后血清总胆红素水平由(266.23±108.87)μmol/L降至(153.08±98.63)μmol/L;其余直接胆红素、谷丙转移酶、谷草转氨酶及碱性磷酸酶水平差异均具有统计学意义(P<0.01),但白蛋白水平未见明显变化(P=0.252)。术后并发症发生率12.0%,无严重并发症发生。中位支架通畅时间122 d(17~833 d),中位生存时间151 d(17~915 d)。结论经皮多支架置入治疗BismuthⅡ型及以上肝门部胆管癌有良好的安全性与有效性,可以一定程度上解决黄疸,恢复患者肝功能。Objective To evaluate the efficacy and safety of percutaneous multi-metal stent insertion in the treatment of hilar cholangiocarcinoma with Bismuth-Corlette typeⅡor above,and analyze the stent patency and overall survival.Methods During the period from January 2019 to September 2021,the clinical data of patients with BismuthⅡor above hilar cholangiocarcinoma who treated with multi-metal stent insertion in Department of Vascular Surgery,Suzhou Municipal Hospital Affiliated to Nanjing Medical University were analyzed retrospectively.The technical success,clinical success,complications,stent patency,and overall survival were evaluated.Results 108 patients were enrolled,aged from 38 to 92,and the average was(66.8±10.6)years old.Technical success was 100%,and successful drainage was achieved in 91 of 108(84.3%)patients.After the procedure,the total bilirubin level decreased from(266.23±108.87)μmol/L to(153.08±98.63)μmol/L.Besides,the level of direct bilirubin,alanine transferase,aspartate aminotransferase and alkaline phosphatase were significantly decreased(P<0.01),however there was no significant change in albumin level(P=0.252).Incidence of complications was 12.0%,and no major complications occurred.The median stent patency was 122 days(range,17~833 days),and the median survival time was 151 days(range,17~915 days).Conclusions Percutaneous multi-metal stent insertion may offer a safe and effective way for patients with BismuthⅡor above hilar cholangiocarcinoma to solve jaundice and recover liver function in a certion extent.

关 键 词：金属多支架 胆管癌 支架通畅期 生存期 

分 类 号：R735.8[医药卫生—肿瘤]