两种胆道支架治疗胰头癌致恶性胆道梗阻疗效探析.docVIP

两种胆道支架治疗胰头癌致恶性胆道梗阻疗效探析【摘要】 目的 探讨ERCP途径置两种胆道支架（塑料支架ERBD、金属支架EMBE）治疗胰头癌致恶性胆道梗阻的疗效。方法 胰头癌致恶性胆道梗阻患者36例，经内镜放置胆道塑料支架（ERBD）或金属支架（EMBE）。观察术后疗效并进行随访，分析比较两种支架近期和远期的疗效。结果 手术成功率95%，术后效果满意，未出现严重并发症。随访36例患者，6个月、1年、2年生存率分别为88．8%、44．4%、19．4%，超过3年者1例。ERBD平均通畅期87 d，更换支架2次以上者7例，住院时间明显长于EMBE，治疗总费用高于EMBE。结论 ERCP途径置两种胆道支架治疗胰头癌所致恶性胆道梗阻，疗效确切。EMBE效果明显优于ERBD。 【关键词】胰头癌；恶性胆道梗阻；胆道支架；ERBD；EMBE The Effect of Biliary Stent in the Treatment of M alignant Biliary Obstruction Caused by Pancreatic Head Carcinoma LIU Ke-xia, CHEN Jun-rong, WANG Xi-yan,et al.Department of General Surgery, Cangzhou Central Hospital, Cangzhou 061001, China 【Abstract】 Objective To investigate the therapeutic effect of biliary metal stent or plastic stent inserted by ERCP in the treatment of m alignant biliary obstruction caused by pancreatic head carcinoma.Methods Biliary biliary metal stents or plastic stents were inserted in 36 patients with m alignant biliary obstruction caused by pancreatic head carcinoma.Then the therapeutic effect and the survival rates at the point of 6 months, 1 year and 2 years later were observed.Results The accomplished was 95%.No severe operation-related complication was present.The follow- up investigation in 36 patients indicated that the survival rates of 6 months, 1 year and 2 years after the operation were 88．8%, 44．4%, 19．4% respectively.The survival time has been more than 3 years in 1 cases.In the cases treated by ERBD, the average unobstructed period was 87 days, 4 patients expericenced 2 0r more times plastic stent implantation, the hospitalization time was longer and the medical expenditure was higher then that cases treated by EMBE.Conclusion The endoscopic biliary stent insertion is an effective and safe therapy for m alignant biliaryoobstruction caused by pancreatic head carcinoma.The therapeutic effect of EMBE was obviously superior to that of ERBD. 【Key words】Pancreatic head carcinoma;M alignant biliary obstruction;Biliary stent;ERBD;EMBE 胰头癌患者主要表现为胆道梗阻，绝大部分病人因