摘要
目的:探讨应用金属内支架治疗复杂型肝门部胆管癌,特别是侵犯肝内胆管的肝门部胆管癌的介入治疗方法。资料与方法:肝门部胆管癌病人梗阻性黄疸32例,并发肝脓肿5例。首先行经皮经肝胆管引流术(PTBD),充分引流后行胆道内支架留置术。结果:共置入引流管63条,内支架67枚,其中29例使用2枚内支架,3例使用3枚内支架。10例行2枚支架T型置入,15例行2枚支架Y型置入,4例行2枚支架X型置入,2例行2枚支架Y型置入后,又选择仍有扩张的一组胆管置入第3枚支架,1例行3枚支架置入。5例脓肿全部消失,全部病人血清胆红素在治疗后好转或恢复到正常水平,随访6个月均无黄疸再发。结论:对于复杂型肝门部胆管癌,胆道内支架治疗是一种有效的改善病人生存质量的方法。特别对于病变侵犯肝内胆管的病例,应选择不同的穿刺路径及支架留置方法,尽可能解决更多肝段的胆管引流。
Objective: To evaluate the value of metallic stent in the treatment of hilar cholangiocarcinoma, especially in the complicated cases of which the hepatic ducts were invaded. Materials and Methods: In the 32 obstructive jaundice cases of hilar cholangiocarcinoma, 5 cases were complicated by abscess of liver. PTBD was performed first, and then metallic stents were deployed after several days of catheter drainage. Results: Sixty-three catheters were inserted and 67 metallic stents were deployed. Two stents were deployed at the same time in 29 cases, and 3 stents were deployed in 3 cases. Two stents were used as T-type in 10 cases. Two stents were used as Y-type in 15 cases and 2 stents were used as X-type in 4 cases. After 2 stents were used as Y-type in 2 cases, there was still a group of hepatic ducts dilated. Thus one more stent was deployed in this group of hepatic ducts. Three stents were directly used in one case. Five cases of abscess of liver were cured and in all cases serum bilirubin level were decreased or reduced to standard level. Jaundice did not recur after 6 months of follow up. Conclusion: The deployment of metallic stent is an effective method to treat complex hilar cholangiocarcinoma, especially for the cases of which hepatic ducts are invaded, the hepatic ducts should be drained as much as possible.
出处
《中国临床医学影像杂志》
CAS
北大核心
2005年第7期383-386,共4页
Journal of China Clinic Medical Imaging
关键词
胆管癌
放射学
介入性
cholangiocarcinoma
radiology, interventional
