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目的观察胆管癌外科术后阻塞性黄疸的介入治疗疗效。方法回顾性分析1998年12月～2009年10月驻马店市中心医院收治的25例胆管癌外科术后出现阻塞性黄疸并采取介入治疗的患者临床资料,观察其疗效。结果 25例患者的总胆红素和直接胆红素水平1个月内由术前的(211.1±118.0)μmol/L和(146.5±86.9)μmol/L降为术后的(105.8±68.6)μmol/L和(80.2±49.2)μmol/L,下降显著(P﹤0.05)。15例患者PTC术中行胆道钳夹活检,技术成功率100%,未出现消化道出血、穿孔等并发症。其中10例根治性切除患者于胆肠吻合口处行钳夹活检,3例病理提示瘢痕性狭窄,给予内外引流管置入;7例为肿瘤复发,6例给予胆道金属支架置入,1例给予内外引流管置入。结论 (1)胆管癌外科术后阻塞性黄疸患者采取介入方法降黄效果明显,操作简单,并发症少;(2)PTC术中胆道活检诊断胆肠吻合口狭窄操作简单,准确。
Objective To observe the effect of interventional therapy of obstructive jaundice after cholangiocarcinoma surgery. Methods The clinical data of 25 patients with obstructive jaundice admitted to Zhumadian Central Hospital from December 1998 to October 2009 were retrospectively analyzed. The curative effect was observed. Results The total bilirubin and direct bilirubin levels in 25 patients decreased from (211.1 ± 118.0) μmol / L and (146.5 ± 86.9) μmol / L to (105.8 ± 68.6) μmol / L and (80.2 ± 49.2) μmol / L, significantly decreased (P <0.05). Fifteen patients underwent PTC with biopsy of the biliary tract, the technical success rate was 100%, no complications such as gastrointestinal bleeding and perforation occurred. Among them, 10 patients underwent radical biopsy at the anastomotic cholangiojejunostomy, 3 had cicatricial stenosis and were treated with internal and external drainage catheters. Tumors were recurred in 7 patients, 6 patients underwent biliary metal stent placement, and 1 patient To give internal and external drainage tube placement. Conclusions (1) Obstructive jaundice in cholangiocarcinoma patients with interventional methods to reduce the yellow effect is obvious, simple operation, fewer complications; (2) PTC biopsy diagnosis of biliary and intestinal anastomotic stenosis is simple and accurate.