摘要
目的探讨应用金属内支架治疗复杂型肝门部胆管癌,特别是侵犯肝内胆管的肝门部胆管癌的介入治疗方法。方法肝门部胆管癌45例,其中 BismuthⅡ型12例、Ⅲa型17例、Ⅲb型10例、Ⅳ型6例。45例均先行经皮经肝胆管引流术后实施胆管内支架置入术,分别以 T、Y、X 型或其组合方式留置2或3枚内支架。结果 45例患者内支架96枚全部置入成功,治疗后胆红素[(312±249)μmol/L]与治疗前[(51±42)μmol/L]相比明显下降(t=4.21,P<0.01),支架置入后30 d 内病死率为2.2%(1/45)。平均支架开通时间181.5 d(26～473 d),平均生存时间215.3 d(26～516 d)。结论对于复杂型肝门部胆管癌,胆管内支架治疗是一种有效改善患者生存质量的方法。特别对病变侵犯肝内胆管的病例,应选择不同的穿刺路径及支架留置方法,尽可能解决更多肝段的胆管引流。
Objective To evaluate the clinical efficacy of multiple stents placement in the management of hilar cholangiocareinoma, especially in the complex cases of which the hepatic ducts are invaded. Methods Forty-five consecutive patients with hilar cholangiocarcinoma were treated with pereutaneous transhepatic placement of two or three self-expandable metallic endoprostheses. The cause of hilar obstructions in these patients were all cholangiocarcinoma, including Bismuth classification type Ⅱ （ n 12）,Ⅲ a （ n 17）, Ⅲ b （ n 10）, and IV （ n 6）. Two or 3 stents were placed in the configuration of T, Y or X over the strictures. Results Stent placement with 2 or 3 endoprostheses was successful in all patients. All patients showed significant decrease in serum bilirubin level. The mortality rate within 30 days of stent placement was 2.2% （ 1/45 ）. The mean survival and stent patency times were 215.3 d （ 26 -- 516 d） and 181.5 d （ 26 -- 473 d） , respectively. Conclusion Deploying of multiple metallic stents is an effective method to treat complex hilar cholangiocarcinoma, especially for the cases of which hepatic ducts are invaded; the hepatic ducts should be drained as much as possible.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2007年第11期1228-1231,共4页
Chinese Journal of Radiology
基金
辽宁省教育厅资助课题(05L571)
关键词
胆管癌
支架
存活率
Cholangiocarcinoma
Stent
Survival rate
