摘要
目的:探讨金属支架置入治疗胆道梗阻微创治疗的价值。方法:回顾分析212例患者行经内镜胆道金属支架引流术治疗恶性胆道梗阻的资料,探讨其治疗价值。在结合临床、影像学资料及尽可能获得的病理基础上确立恶性胆道梗阻,直接或在经内镜鼻胆管引流术(ENBD)、经内镜塑料内支架引流术(ERBD)过渡引流确定引流效果后行经内镜金属支架引流术(EMBE),并与姑息性手术及ERBD进行对照研究。结果:一次操作成功率99.5%,减黄有效率为:满意68.4%,一般27.5%,无效4.1%;其中低位梗阻减黄有效率(满意+一般)达96.6%,高位梗阻减黄有效率82.4%,支架平均通畅期289d,平均生存期310d,并发症率6.7%,死亡率1.2%。结论:在严格掌握适应证的基础上,经内镜金属支架引流术(EMBE)是安全有效解除恶性胆道梗阻的方法,对中晚期胆道肿瘤患者基本可替代姑息性胆道手术治疗。
AIM： To evaluate the therapeutic value of endoscopic metal stent implantation for malignant biliary obstruction. METHODS： Clinical data of 212 patients with malignant biliary obstruction undergoing endoscopic biliary drainage were retrospectively analyzed. Based on the clinical and imaging data, malignant biliary obstruction was identified and according to drainage effect of endoscopic nasobiliary drainage and endoscopic retrograde biliary drainage （ERBD）, endoscopic metal biliary endoprothesis was conducted and compared with palliative endoscopic drainage and ERBD. RESULTS： The success rate of one-off operation was 99.5%. For jaundice release, 68.4% of the cases were satisfactory, 27.5% were released, and 4.1% had no effect. The effective rate of jaundice release （satisfactory ＋ release） in obstruction at low site was 96.6% and that at high site was 82.4%. Average duration of obstruction release was 289 days and average survival was 310 days. The complication rate was 6.7% with a mortality rate of 1.2%. CONCLUSION： Based on rigorous indication selection, EMBE is as a safe and effective therapeutic means to remove malignant biliary obstruction. EMBE may replace palliative biliary surgery for patients with mid-late stage biliary tumors.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2008年第35期6944-6946,共3页
Journal of Clinical Rehabilitative Tissue Engineering Research
