论文部分内容阅读
目的:探讨经内镜胆道支架置入术姑息性治疗肝门部胆管癌的临床优劣势。方法:回顾性分析我院2013年1月~2015年1月收治的68例经内镜胆道支架置入术姑息性治疗肝门部胆管癌患者临床资料,设为内镜组。同期将我院收治的62例行经皮经肝穿刺胆道支架置入术治疗肝门部胆管癌设为经肝组。比较两组患者置入成功率、术后并发症及肝功能方面的差异。结果:内镜组患者胆道支架置入成功率为82.4%低于经肝组95.2%;内镜组患者术后胆道感染、胰腺炎发生率分别为22.1%、8.8%高于经肝组4.8%、0%,胆道出血发生率为1.5%低于经肝组19.4%,而内镜组肝脓肿发生率无明显差异;治疗后内镜组患者ALT、TBil显著下降。结论:经内镜胆道支架置入术姑息性治疗肝门部胆管癌效果显著,其置入成功率高,胆道出血少,有效改善患者肝功能,但其胆道感染及胰腺炎的发生率较高,而经皮经肝穿刺胆道感染及胰腺炎发生较少。
Objective: To investigate the clinical advantages and disadvantages of endoscopic biliary stenting for palliative treatment of hilar cholangiocarcinoma. Methods: The clinical data of 68 patients with hilar cholangiocarcinoma undergoing endoscopic biliary stenting in our hospital from January 2013 to January 2015 were retrospectively analyzed. The endoscopic group was included. In the same period, 62 cases of percutaneous transhepatic biliary stenting were treated in our hospital for treatment of hilar cholangiocarcinoma as transhepatic group. The success rates of postoperative complications, postoperative complications and liver function were compared between the two groups. Results: The success rate of biliary stenting in endoscopic group was 82.4%, lower than 95.2% in liver group. The incidences of postoperative biliary tract infection and pancreatitis in endoscopic group were 22.1% and 8.8% , 0%, the incidence of biliary tract bleeding was 1.5% lower than the liver group 19.4%, while the incidence of endoscopic liver abscess no significant difference; after treatment endoscopic group ALT, TBil significantly decreased. Conclusions: Palliative treatment of hilar cholangiocarcinoma by endoscopic biliary stenting is effective, with high success rate of implantation, less biliary tract bleeding and effective improvement of liver function, but the incidence of biliary tract infection and pancreatitis is high , While percutaneous transhepatic biliary tract infection and pancreatitis less.