CAJ | 학술논문

目的探讨经十二指肠镜放置胆道支架(EMBE、ERBD)和鼻胆管引流姑息治疗恶性梗阻性黄疸的有效性及临床应用价值.方法回顾性分析2002年6月至2009年3月51例有绝对或相对手术禁忌证的恶性梗阻性黄疸病人成功行经内镜胆道支架置入术的有效率、并发症发生率、支架通畅时间及生存时间.结果 51例病人中,置入金属支架31例,置人塑料支架15例,2例单纯置入鼻胆管引流.其中黄疸指数下降48例,总胆红素从(279.6±143.7)μmol/L一周后下降到(125.7±78.3)μmol/L(P＜0.01).出现急性胰腺炎并发腹痛者3例,高淀粉酶血症9例,发生胆绞痛者1例,贲门撕裂伴大出血1例,并发症发生率27.4%;支架通畅时间119 d;置入支架组随访39例,3个月、6个月生存率达到91%和74%.结论通过十二指肠镜进行胆道支架置入和有效引流是姑息治疗恶性梗阻性黄疸的有效方法.
목적 탐토경십이지장경방치담도지가(EMBE、ERBD)화비담관인류고식치료악성경조성황달적유효성급림상응용개치.방법 회고성분석2002년6월지2009년3월51례유절대혹상대수술금기증적악성경조성황달병인성공행경내경담도지가치입술적유효솔、병발증발생솔、지가통창시간급생존시간.결과 51례병인중,치입금속지가31례,치인소료지가15례,2례단순치입비담관인류.기중황달지수하강48례,총담홍소종(279.6±143.7)μmol/L일주후하강도(125.7±78.3)μmol/L(P＜0.01).출현급성이선염병발복통자3례,고정분매혈증9례,발생담교통자1례,분문시렬반대출혈1례,병발증발생솔27.4%;지가통창시간119 d;치입지가조수방39례,3개월、6개월생존솔체도91%화74%.결론 통과십이지장경진행담도지가치입화유효인류시고식치료악성경조성황달적유효방법.
Objective To investigate the clinical value and therapeutic effect of biliary stent insertion(EMBE, ERBD)and ENBD via endoscopic retrograde cholangio-pancreatography(ERCP)on malignant obstructive jaundice.Methods A retrospective review was conducted of 51 patients with malignant obstructive jaundice receiving ERCP in our hospital from June 2002 to March 2009.Different biliary stents or ENBD were placed into their biliary duct to drain bile.Meanwhile, the efective power, incidence rate, unobstructive time, and live time were determined.Results ERCP was successfully performed in all these 51 cases and 31 of them were successfully embedded with self-expandable metal stents while 15 of them had plastic stents.The last 2 cases were only treated with ENBD.Eleven cases had complications, but none of them had sequela after prompt treatment.In 48 cases, the serum level of total bilirubin decreased from(279.6±143.7)μmol/L to(125.7±78.3)μmol/L after drainage(P＜0.01).The follow-up investigation in 39 cases indicated that the 3-and 6-month survival rates after the treatment were 91% and 74%, respectively.Conclusion Biliary stent insertion and ENBD via duodenoscopy is an effective and safe palliative treatment for malignant bile duct obstruction.