Wakabayashi M
Department of Radiology, St. Marianna University School of Medicine.
Nihon Igaku Hoshasen Gakkai Zasshi. 1992 Nov 25;52(11):1571-81.
Three types of expandable metallic stents were used to relieve obstructive jaundice in 59 patients. They consisted of 3 cases with benign stricture, and 56 with malignant obstruction including 28 of cholangiocarcinoma, 17 of pancreatic carcinoma, 9 of lymph node metastases, and 2 of gall bladder carcinoma. The median age of patients was 68.9 years. Of 56 cases with malignant obstruction, 51 cases were able to remove external drainage catheter. In these 51 cases, 35 patients died, and 16 are still alive. No significant difference was noted in the incidence of stent destruction or migration in three types of stents. The average survival period was 189.9 days in 35 patients who died after withdrawal of external drainage. Twenty-three of 35 patients had no recurrence of obstructive jaundice. Sixteen patients with malignant obstruction are still alive and have been observed for 22 to 764 days. The 30 day mortality rate was 6.8%. Three cases of acute cholecystitis were noted after procedure. It is warranted to say that endoprostheses using expandable metallic stents will be the major treatment of choice for biliary obstruction because of long term patency and low complication rate.
三种类型的可扩张金属支架被用于缓解59例患者的梗阻性黄疸。其中包括3例良性狭窄患者，56例恶性梗阻患者，后者包括28例胆管癌、17例胰腺癌、9例淋巴结转移癌和2例胆囊癌。患者的中位年龄为68.9岁。在56例恶性梗阻患者中，51例能够拔除体外引流导管。在这51例患者中，35例死亡，16例仍存活。三种类型的支架在支架破坏或移位发生率方面未观察到显著差异。35例拔除体外引流后死亡的患者平均生存期为189.9天。35例患者中有23例未出现梗阻性黄疸复发。16例恶性梗阻患者仍存活，观察时间为22至764天。30天死亡率为6.8%。术后发现3例急性胆囊炎。可以有把握地说，由于长期通畅性和低并发症发生率，使用可扩张金属支架的内假体将成为胆管梗阻的主要治疗选择。
