论文部分内容阅读
目的探讨内窥镜逆行胰胆管造影术(ERCP)或经皮肝穿刺胆管引流术(PTCD)行胆管支架置入在恶性梗阻性黄疸(MOJ)临床治疗中的优势。方法回顾性分析32例MOJ患者的临床资料,先经ERCP途径放置胆管支架,不成功则应用PTCD放置胆管支架。结果所有患者胆管支架均置入成功,术后1周血清总胆红素、谷丙转氨酶、谷氨酰转肽酶明显减低(P均<0.05);并发症:发生胆管炎3例、经抗生素治疗后好转,全组无一例出现胆漏、穿孔等并发症。结论经ERCP或PTCD放置胆道支架可有效治疗MOJ患者的胆管梗阻,提高治疗的安全性和有效性,可作为恶性胆道梗阻患者的首选姑息治疗方法。
Objective To investigate the advantages of endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic biliary drainage (PTCD) in the treatment of malignant obstructive jaundice (MOJ). Methods The clinical data of 32 patients with MOJ were retrospectively analyzed. The biliary stents were placed by ERCP first and the biliary stents were placed by PTCD unsuccessfully. Results All the biliary stents were successfully inserted. The levels of total bilirubin, alanine aminotransferase and glutamyl transpeptidase were significantly decreased 1 week after operation (all P <0.05). Complication: 3 cases of cholangitis occurred and antibiotics After treatment, there was no case of bile leakage, perforation and other complications in the whole group. Conclusion The placement of biliary stents by ERCP or PTCD can effectively treat biliary obstruction in patients with MOJ and improve the safety and efficacy of treatment. It may be the first choice of palliative treatment for patients with malignant biliary obstruction.