Feng Guang-Hua, Cai Yang, Jia Zhong, Yang De-Qi, Chen Hu, Jin Hui-Cheng, Yu Qiang-Hong, Zhu Wei, Wang Chu-Xiong
Department of General Surgery, First People's Hospital, 261 Huansha Road, Hangzhou 310006, China.
Hepatobiliary Pancreat Dis Int. 2003 May;2(2):300-2.
To assess the short-term results of interventional therapy for malignant obstructive jaundice.
In 82 patients with malignant obstructive jaundice, hepatocellular carcinoma was detected in 10 patients, carcinoma of gallbladder in 14, hilar biliary carcinoma in 22, pancreatic carcinoma in 20, and hilar metastatic carcinoma in 16. Percutaneous transhepatic biliary internal and/or external drainage (PTBIED) was performed in 61 patients and percutaneous transhepatic insertion of biliary stent (PTIBS) in 21.
The level of total serum bilirubin (TSB) was reduced in 71 patients and less markedly in others. The level of TSB of the 61 patients was reduced from 450.12+/-113.51 micromol/L before operation to 240.25+/-107.81 micromol/L and 90.91+/-101.72 micromol/L 1 and 2 weeks after operation respectively. The TSB level of the 21 patients was reduced from 410.53+/-98.13 micromol/L to 270.23+/-115.64 micromol/L and 105.43+/-97.85 micromol/L 1 and 2 weeks after operation, respectively. No significant difference was found in the effect between PTBIED and PTIBS. Short-term complications developed in 33 patients. Seven patients died 30 days after operation.
Interventional therapy may be simple, safe and effective in the treatment of malignant obstructive jaundice.
评估恶性梗阻性黄疸介入治疗的短期效果。
82例恶性梗阻性黄疸患者中，肝细胞癌10例，胆囊癌14例，肝门部胆管癌22例，胰腺癌20例，肝门部转移癌16例。61例行经皮肝穿刺胆道内外引流术（PTBIED），21例行经皮肝穿刺胆道支架置入术（PTIBS）。
71例患者血清总胆红素（TSB）水平降低，其他患者降低不明显。61例患者术前TSB水平为450.12±113.51μmol/L，术后1周和2周分别降至240.25±107.81μmol/L和90.91±101.72μmol/L。21例患者术前TSB水平为410.53±98.13μmol/L，术后1周和2周分别降至270.23±115.64μmol/L和105.43±97.85μmol/L。PTBIED和PTIBS的效果差异无统计学意义。33例患者出现短期并发症。7例患者术后30天死亡。
介入治疗恶性梗阻性黄疸可能简单、安全且有效。
