摘要
目的探讨可膨式金属胆道支架术解除恶性胆管梗阻的中远期疗效及初步分析影响疗效的因素。方法１３４例各类恶性肿瘤导致胆管梗阻的患者接受金属支架放置术，其中内镜下经乳头放置１２８例，经皮经肝放置６例，随访引流效果并与同期９７例内镜下放置塑料支架的患者进行对比。结果操作成功率９５７％，并发症６４％，黄疸消除率８５６％，金属支架的平均通畅期为３００天，明显高于塑料支架的８０天（Ｐ＜００１）；平均存活期为２１０天。原发性胆管肿瘤的支架通畅性与继发性肿瘤接近，而平均生存期略长；高位胆管梗阻的支架通畅期和存活期与中低位梗阻相仿。结论可膨式金属胆道支架的平均通畅性能显著优于普通塑料支架，提高疗效的关键是严格掌握适应证。
Objective To investigated the longterm
result of expandable metallic biliary stent implantation and evaluated preliminarily the factors
that might impact the therapeutic effectiveness.Methods 134 patients with malignant
choledochal stenosis were treated with metallic endoprotheses (128 transpapillary
endoscopically and 6 transhepatic percutaneously). The followup results were compared with
those of 97 patients with conventional plastic stents during the same period. Results The
success rate was 957%,and the procedure related complications were found in 64% of patients.
The jaundice was eliminated completely in 856% patients. During longterm followup, the metal
stents were shown patent for a mean duration of 300 days, which was significantly longer than
80 days of polyethylene endoprostheses (P<001). The mean survival was 210 days. From
classified data assessment, the stent patency in primary bile duct neoplasm group was almost
similar to that in metastatic group, but the median survival of the former was slightly longer
than that of the latter. There were flow differences in patancy and survival rates between the
hilar obstruction group and the middle and low obstruction group. Conclusions The median
patancy of expandable metal stents was significantly longer than that of conventional plastic
prostheses. To get the highest benefit, however, the indication should be strictly selected.
出处
《中华外科杂志》
CAS
CSCD
北大核心
1999年第5期282-285,共4页
Chinese Journal of Surgery
关键词
胆道肿瘤
胆管梗阻
金属胆道支架术
可膨式
Biliary tract neoplasmJaundiceCholangiopancreatography, endoscopic retrograde
