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目的探讨纤维十二指肠镜逆行胆胰管造影(ERCP)置放胆道内支架姑息治疗恶性胆道梗阻的临床疗效。方法通过ERCP将导丝插入33例恶性肿瘤引起的梗阻性黄疸患者的胆道并超过梗阻部位,扩张狭窄,然后用推送导管将引流支架推送至胆道狭窄部位,其两端均超过狭窄段1 cm以上,从而解除33例恶性肿瘤引起的梗阻性黄疸。结果 33例患者中插管成功29例,不成功4例,成功率为87.88%(29/33)。术后黄疸逐渐消退,皮肤瘙痒等症状消失或减轻。术后2周内血清总胆红素均下降50%以上,血清总胆红素均退至40μmol/L,肝功能较术前显著改善(P<0.05)。结论通过ERCP内镜下胆道内置放支架,解除恶性梗阻性黄疸,对缓解症状、提高患者生存质量具有满意疗效。
Objective To investigate the clinical effect of fiberoptic duodenoscopic retrograde cholangiopancreatography (ERCP) on biliary stent placement in treatment of malignant biliary obstruction. Methods The guide wire was inserted into the biliary tract of the obstructive jaundice caused by malignant tumor by ERCP and expanded beyond the obstruction site. The stent was then pushed to the site of biliary stricture by pushing catheters, and both ends of the stent were over 1 cm above the stenosis , Thus lifting the 33 cases of obstructive jaundice caused by malignant tumors. Results In 33 patients, intubation was successful in 29 cases, unsuccessful in 4 cases, the success rate was 87.88% (29/33). Jaundice gradually subsided, the skin itching and other symptoms disappear or reduce. Serum total bilirubin decreased more than 50% within 2 weeks after operation, total serum bilirubin retreated to 40 μmol / L, and liver function improved significantly (P <0.05). Conclusion ERCP endoscopic placement of stents to relieve malignant obstructive jaundice has a satisfactory effect on relieving symptoms and improving the quality of life of patients.