经皮经肝单侧入路行双侧胆管内引流术的临床应用  

Application of Intra-Drainage for Bilateral -Hepatic Duct Systems by One-Sided Percutaneous Transhepatic Biliary Puncture

作　　者：徐克[1] 刘瑞宝[2] 赵仲春[1] 张曦彤[1] 冯博[1] 周玉斌[1] 富宏[1] 

机构地区：[1]中国医科大学附属第一医院放射科,辽宁沈阳110001 [2]哈尔滨医科大学附属三院

出　　处：《中国医学影像技术》2003年第8期1047-1049,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的　评价经单侧入路左、右肝胆管内支架和 /或内涵管引流术治疗肝门部肿瘤所致左、右肝胆管同时受累的恶性梗阻性黄疸 (MOJ)的疗效及临床价值。方法　 12例左、右肝内胆管同时受累的MOJ病人 ,经皮经左肝或右肝单侧入路 ,通过在左 右肝管间和肝管 胆总管间置入金属内支架或内涵管行胆管内引流。结果　 12例MOJ病人左 右肝管间、肝管 胆总管间共置入内支架 16枚 ,内涵管 8个。 2周后血清胆红素水平从治疗前 ( 3 75± 5 2 .98) μmol/L下降到 ( 117.0 8± 3 9.0 9) μmol/L。 3～ 6个月复查内引流均通畅 ,无严重并发症发生。结论　经单侧入路双侧肝管内引流术是治疗左 右肝管同时受累型MOJ的一项创伤小、费用低 ,既安全有效又经济实用的介入治疗新技术。Objective To evaluate the effect and value of percutaneous intra drainage of bilateral hepatic duct systems through stent and /or plastic stent that inserted via one sided puncture in patients with malignant obstructive jaundice (MOJ) that both sides of duct involved secondary to hepatic hilar tumor. Methods Intra drainage for bilateral liver lobes were performed through stents that inserted between right left intrahepatic duct and hepatic common duct via one sided puncture in 12 consecutive patients of MOJ. Results Sixteen metal and 8 plastic stents were implanted between dilated bilateral intrahepatic and hepatic common bile duct in 12 MOJ patients. The elevated serum bilirubin level reduced from 375±52.98μmol/L to 117.08±39.09μmol/L 2 weeks after drainage without any serious complication occurred. No reobstruction founded during 3-6 months follow up. Conclusion Intra draining of bilaterallhepatic ducts via one sided puncture is a new practical interventional technique in the treatment of MOJ patients with both sides of hepatic duct system involved, and it's a less invasive alternative while inexpensive and safe.

关 键 词：恶性梗阻性黄疸 内引流术 介入治疗 放射学 

分 类 号：R815[医药卫生—放射医学] R575[医药卫生—临床医学]