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目的:探讨老年恶性梗阻性黄疸行ERCP或PTBD的临床应用价值。方法:83例恶性梗阻性黄疸患者.男性69例,女性14例,年龄59岁～85岁。其中胆管癌18例,胰头癌48例,肝癌7例,转移癌(胃癌)10例。所有病例经临床、病理和影像学检查诊断为恶性梗阻性黄疸,且失去手术机会。43例行ERCP,40例行PTBD。结果:ERCP内引流成功38例,所有PTBD术全部引流成功,引流术后两周血清胆红素水平明显较治疗前下降。生存时间最短26 d,最长16个月。结论:ERCP或PTBD对晚期恶性梗阻性黄疸患者是一种良好的降低黄疸的姑息性治疗方法。
Objective: To investigate the clinical value of ERCP or PTBD in elderly patients with malignant obstructive jaundice. Methods: 83 patients with malignant obstructive jaundice, 69 males and 14 females, aged from 59 to 85 years old. Including cholangiocarcinoma in 18 cases, 48 cases of pancreatic head cancer, liver cancer in 7 cases, metastatic carcinoma (gastric cancer) in 10 cases. All cases were diagnosed as malignant obstructive jaundice by clinical, pathological and imaging examination, and the chance of operation was lost. 43 cases of ERCP, 40 cases of PTBD. Results: Thirty-eight patients were successfully treated with ERCP, all of them were successfully drained by PTBD. The level of serum bilirubin in two weeks after drainage was significantly lower than that before treatment. The shortest survival time of 26 d, up to 16 months. Conclusions: ERCP or PTBD is a palliative treatment for jaundice in patients with advanced malignant obstructive jaundice.