国际外科学杂志
國際外科學雜誌
국제외과학잡지
INTERNATIONAL JOURNAL OF SURGERY
2014年
8期
528-533
,共6页
王翀%乔安意%李柱%屈荣荣%黄经昊
王翀%喬安意%李柱%屈榮榮%黃經昊
왕충%교안의%리주%굴영영%황경호
胆道肿瘤%胆管,肝外%黄疸,阻塞性%姑息疗法%引流术
膽道腫瘤%膽管,肝外%黃疸,阻塞性%姑息療法%引流術
담도종류%담관,간외%황달,조새성%고식요법%인류술
Biliary tract neoplasms%Bile ducts,extrahepatic%Jaundice,obstructive%Palliative therapy%Drainage
目的 比较开腹胆道旁路手术与两种胆道支架置入术针对胆管癌的姑息性减黄治疗的效果及适应证.方法 收集2008年3月-2013年3月广州医科大学第三附属医院接受姑息性减黄治疗的69例胆管癌患者临床资料,其中行开腹旁路手术者17例;接受介入治疗者共52例(接受经皮肝穿刺胆道支架置入术者25例,经内镜胆道支架置入术治疗者27例).比较经不同引流方式后胆管癌患者近期减黄率、平均住院时间、病死率、相关并发症发病率等.结果 不同引流方式均有较好的减黄效果,减黄率差异无统计学意义(P＞0.05);在住院时间和术后生存期上,介入治疗较开腹旁路手术者有明显优势(P＜0.05).在不同介入方式之间,内镜组胰腺炎的发病率明显高出经皮组(P＜0.05);胆道感染及出血的发病率则差异无统计学意义(P＞0.05);各型肝外胆管癌患者接受不同介入支架置入术的成功率之间差异无统计学意义(P＞0.05).结论在胆管癌的姑息性减黄治疗手段当中,介入支架置入内引流术在住院时间和术后生存期上要优于开腹胆道旁路手术.在不同介入方式当中,首选经内镜胆道支架置入术.
目的 比較開腹膽道徬路手術與兩種膽道支架置入術針對膽管癌的姑息性減黃治療的效果及適應證.方法 收集2008年3月-2013年3月廣州醫科大學第三附屬醫院接受姑息性減黃治療的69例膽管癌患者臨床資料,其中行開腹徬路手術者17例;接受介入治療者共52例(接受經皮肝穿刺膽道支架置入術者25例,經內鏡膽道支架置入術治療者27例).比較經不同引流方式後膽管癌患者近期減黃率、平均住院時間、病死率、相關併髮癥髮病率等.結果 不同引流方式均有較好的減黃效果,減黃率差異無統計學意義(P＞0.05);在住院時間和術後生存期上,介入治療較開腹徬路手術者有明顯優勢(P＜0.05).在不同介入方式之間,內鏡組胰腺炎的髮病率明顯高齣經皮組(P＜0.05);膽道感染及齣血的髮病率則差異無統計學意義(P＞0.05);各型肝外膽管癌患者接受不同介入支架置入術的成功率之間差異無統計學意義(P＞0.05).結論在膽管癌的姑息性減黃治療手段噹中,介入支架置入內引流術在住院時間和術後生存期上要優于開腹膽道徬路手術.在不同介入方式噹中,首選經內鏡膽道支架置入術.
목적 비교개복담도방로수술여량충담도지가치입술침대담관암적고식성감황치료적효과급괄응증.방법 수집2008년3월-2013년3월엄주의과대학제삼부속의원접수고식성감황치료적69례담관암환자림상자료,기중행개복방로수술자17례;접수개입치료자공52례(접수경피간천자담도지가치입술자25례,경내경담도지가치입술치료자27례).비교경불동인류방식후담관암환자근기감황솔、평균주원시간、병사솔、상관병발증발병솔등.결과 불동인류방식균유교호적감황효과,감황솔차이무통계학의의(P＞0.05);재주원시간화술후생존기상,개입치료교개복방로수술자유명현우세(P＜0.05).재불동개입방식지간,내경조이선염적발병솔명현고출경피조(P＜0.05);담도감염급출혈적발병솔칙차이무통계학의의(P＞0.05);각형간외담관암환자접수불동개입지가치입술적성공솔지간차이무통계학의의(P＞0.05).결론재담관암적고식성감황치료수단당중,개입지가치입내인류술재주원시간화술후생존기상요우우개복담도방로수술.재불동개입방식당중,수선경내경담도지가치입술.
Objective To compare the efficacy and indications between the biliary bypass laparotomy surgery.and the two different kinds of biliary stent insertion surgery in the palliative alleviating jaundice of cholangiocarcinoma.Methods From March 2008 to March 2013,69 patients treated with palliative alleviating jaundice therapy of cholangiocarcinoma were included,who were all came from the Third Affiliated Hospital of Guangzhou Medical University.Including 17 patients who treated with the open biliary bypass surgery and 52 patients who treated with interventional therapy.We analysed the differences between these cases of biliary drainage operations in the recent jaundice reduction rate,average stay,mortality rate,the incidence of related complications,et al.Results All these different drainage ways had good effect in alleviating jaundice,incidence of alleviating jaundice have no obvious difference (P ＞ 0.05).Compared to the open biliary bypass surgery,interventional therapy had obvious advantages in the average stay and postoperative survival (P ＜ 0.05).The pancreatitis rate was lower in Percutaneous Group than that in Endoscopic Group (P ＜ 0.05).incidence of biliary tract infection and biliary tract bleeding have no obvious difference (P ＞ 0.05).There were no significant differences between the success rates of in biliary stent insertion operation in patients with each model cholangiocarcinoma (P ＞ 0.05).Conclusions Among the therapies of the palliative alleviating jaundice of cholangiocarcinoma,the internal biliary drainage of biliary stent insertion operation was superior to the treatment of the biliary bypass laparotomy.As to biliary stent insertion operations,endoscopic biliary stenting surgery should be the preferred choice.
