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目的探讨经皮肝胆管穿刺金属内支架植入治疗恶性梗阻性黄疸临床应用价值。方法2000年10月～2004年10月,对32例恶性梗阻性黄疸患者施行经皮肝胆管穿刺金属内支架植入。其中胆管癌17例,胰腺癌5例,肝门部转移癌10例。梗阻部位:肝总管肝门区20例,胆总管12例。结果金属内支架植入成功率100%(32/32)。2例出现胆汁性腹膜炎,胆道出血1例。28例术后血清胆红素3～4周降至正常,黄疸完全消失率87.5%(28/32)。生存期3～18个月,平均8个月。3例分别于术后6、8、13个月出现梗阻性黄疸,再梗阻发生率9%(3/32)。结论经皮肝胆管穿刺金属内支架植入是治疗恶性梗阻性黄疸安全、有效的姑息性治疗方法。
Objective To investigate the clinical value of percutaneous transhepatic biliary stent implantation in the treatment of malignant obstructive jaundice. Methods From October 2000 to October 2004, 32 patients with malignant obstructive jaundice were treated with percutaneous transhepatic biliary stent implantation. Including cholangiocarcinoma in 17 cases, pancreatic cancer in 5 cases, hilar metastasis in 10 cases. Obstruction site: hepatic portal area 20 cases of common bile duct in 12 cases. Results Metal stent implantation success rate of 100% (32/32). 2 cases of biliary peritonitis, biliary bleeding in 1 case. 28 cases of postoperative serum bilirubin 3 to 4 weeks reduced to normal, complete disappearance rate of jaundice 87.5% (28/32). Survival of 3 to 18 months, an average of 8 months. Three patients had obstructive jaundice at 6, 8 and 13 months postoperatively respectively, and the incidence of re-obstruction was 9% (3/32). Conclusion Percutaneous transhepatic biliary stent implantation is a safe and effective palliative treatment for malignant obstructive jaundice.