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目的探讨支架置入术在姑息性治疗不能手术的13例胃出口-十二指肠恶性梗阻(GOADO)的可操作性和有效性。方法 13例患者采用经口在内镜下或透视下置入14个自膨式带膜金属支架和同轴双支架治疗不能手术的恶性GOADO。梗阻的原因分别是胃癌7例,胰腺癌3例,结肠癌并肝转移2例,十二指肠癌1例。结果 技术成功率100%,未发生严重的并发症。13例患者症状缓解或消失,随访期间未发现支架移位和肿瘤内生性生长等并发症。患者生活质量明显提高,生存时间明显延长。13例患者中生存6～10月者8例,10～18个者4例,其中3例为胃癌,另有1例胃癌患者生存已超过20个月。结论 经口途径支架置入姑息性治疗不能手术的恶性GOADO是可行的,且有较好的疗效。
Objective To investigate the maneuverability and effectiveness of stent placement in the treatment of 13 cases of gastric outlet duodenal obstruction (GOADO) which is inoperable. Methods Thirteen patients underwent endoscopic or fluoroscopic insertion of inoperable malignant GOADO with 14 self-expandable metal-coated stents and coaxial double stents. The causes of obstruction were 7 cases of gastric cancer, 3 cases of pancreatic cancer, 2 cases of colon cancer and liver metastasis, 1 case of duodenal cancer. Results The technical success rate was 100% without serious complications. Thirteen patients had their symptoms relieved or disappeared. No complications such as stent dislocation and tumor endogenous growth were observed during follow-up. Patients significantly improved the quality of life, survival was significantly longer. Of the 13 patients, 8 were surviving from June to October and 4 were from 10 to 18, of whom 3 were gastric cancer and the other 1 had gastric cancer over 20 months. Conclusion Oral route of stent implantation of palliative treatment of inoperable malignant GOADO is feasible and has a good effect.