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[内镜下在肝外胆管狭窄处植入球囊扩张式内支架(施特雷克尔支架)]

[Endoscopic implantation of balloon expandable endoprostheses (Strecker stents) in extrahepatic bile duct stenoses].

作者信息

Nattermann C, Goldschmidt A J, Dancygier H

机构信息

Medizinischen Klinik II, Städtischen Kliniken, Offenbach am Main.

出版信息

Med Klin (Munich). 1992 Jul 15;87(7):364-8.

PMID:1508116
Abstract

22 balloon expandable wire Strecker-stents were implanted endoscopically in 20 patients (eleven women, nine men, mean age 68.3 [44 to 86] years) with malignant (n = 19) and benign (n = 1) bile duct obstruction. In all cases an effective biliary drainage was obtained. To achieve complete drainage repeated balloon dilatation of the inserted stent was often performed. In two cases stent dislocation occurred immediately after implantation. Additional complications were not observed during the first 30 days. During the observation period of maximally 15 months one patient developed an incomplete occlusion of the stent due to tumor compression that could be reversed endoscopically. In a further patient biliary stones caused relapse of cholestatic jaundice. Four patients died from their malignant disease without evidence of stent occlusion. 15 patients continue to live without renewed jaundice. With the mean observation period of 5.5 months (median five months) this corresponds to a patency rate of 95%. The estimated survival rate according to Kaplan-Meier was 87.7% and the estimated mean survival time 11.7 months. These results demonstrate that in patients with extrahepatic bile duct obstruction an effective biliary drainage can be achieved with balloon expandable wire stents. They represent a further progress in the palliative treatment of patients with extrahepatic obstructive jaundice.

摘要

22个球囊扩张式金属丝Strecker支架经内镜植入20例患者(11名女性,9名男性,平均年龄68.3[44至86]岁),这些患者患有恶性(n = 19)和良性(n = 1)胆管梗阻。所有病例均实现了有效的胆道引流。为实现完全引流,常对插入的支架进行反复球囊扩张。2例患者在植入后立即发生支架移位。在最初30天内未观察到其他并发症。在最长15个月的观察期内,1例患者因肿瘤压迫导致支架不完全闭塞,可通过内镜逆转。在另1例患者中,胆结石导致胆汁淤积性黄疸复发。4例患者死于恶性疾病,无支架闭塞证据。15例患者继续存活,未再次出现黄疸。平均观察期为5.5个月(中位数为5个月),这相当于通畅率为95%。根据Kaplan-Meier法估计的生存率为87.7%,估计平均生存时间为11.7个月。这些结果表明,对于肝外胆管梗阻患者,球囊扩张式金属丝支架可实现有效的胆道引流。它们代表了肝外阻塞性黄疸患者姑息治疗的进一步进展。

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