【摘要】 目的 分析右侧单通道胆道双支架放置技术治疗恶性高位胆管梗阻的临床价值。方法56例肝门部胆管恶性梗阻患者,BismuthⅡ～Ⅳ型48例,右侧单通道双支架放置29例,双通道双支架放置9例,其余10例单支架置入和或胆道引流术。术后4周总胆红素下降≥50%为有效,并进行随访。结果 (1)BismuthⅡ～Ⅳ型48例中单通道胆道双支架植入29例,成功率为6 0.4 2%。(2)右侧单通道胆道双支架植入、双通道胆道双支架植入、单通道胆道单支架植入和/或胆道引流术,4周总胆红素下降率分别为91.45%、90.23%、61.53%,有效率为100%。结论 右侧单通道双支架植入技术比较双通道双支架植入简化了操作,减少了操作创伤及并发症,减少了医师的X线辐射剂量,具有明显的临床实用价值及可行性。更多还原

【Abstract】 Objective To evaluate the clinic value of right single channel biliary tract double stent placement technique in treating malignancy superior position obstruction of bile duct.Methods Among 56 patients of hepatic hilum bile duc malignant obstruction,48 patients with Bismuth Ⅱ-Ⅳ type were enrolled in this study.29 patients were performed right single channel biliary tract stent placemen,9 patients were placed dual pathways double stent and 10 cases were performed single stent placement and/or biliary trac drainage.The utility was total bilirubin descending over 50% post-operation 4 weeks,and follow-up.Results(1)29 Bismuth Ⅱ-Ⅳtype patients were implanted double stands in right single channel,achievement ratio was 60.42%.(2)4 weeks after operation,the48 patients with Bismuth Ⅱ-Ⅳ type descent significantly.The total bilirubin of right single channel biliary tract stent placement group decreased 91.45%,double channel biliary tract double stent placement group decreased 90.23%,single channel biliary single tract stent placement and opposite side draining or biliary tract external drainage group decreased 61.53%.The near future effective rate was 100%.Conclusion The right single channel biliary tract double stent placement technique in treating malignancy superior position obstruction of bile duct reduced the operation of intervention drainage in superior position obstruction of bile duct,decreasing the operation wound and complication,decreasing the X-ray radiation dose on operation doctor,possessing apparente clinical practical value and feasibility.更多还原