Chen Jui-Hao, Sun Cheuk-Kay, Liao Chao-Sheng, Chua Chain-Smoke
Department of Gastroenterology, Shin-Kong Wu-Ho-Su Memorial Hospital, 95 Weng Chang Road, Shih-Lin District, Taipei, Taiwan,China.
World J Gastroenterol. 2006 Jan 7;12(1):119-22. doi: 10.3748/wjg.v12.i1.119.
To compare the efficacy of self-expandable metallic stents (EMS) in the treatment of distal and proximal stricture of malignant biliary tumors.
From March 1995 to June 2004, 61 patients (40 males, 21 females) with malignant biliary obstruction who received self-expandable metallic stent implantation were reviewed retrospectively. The stents were inserted by an endoscopic or percutaneous transhepatic method. We tried to place two stents in the biliary system in T or Y configuration in cases of hilar tumors with bilateral hepatic duct obstruction. The end points of the study were stent occlusion or patient death.
The mean time of stent patency was 421 +/- 67 d in the group of proximal stricture (group I) and 168 +/- 18 d in the group of distal stricture (group II). The difference was significant in borderline between the two groups (P = 0.0567). The mean survival time was 574 +/- 76 d in group I and 182 +/- 25 d in group II. There was a significant difference between the two groups (P = 0.0005).
EMS implantation is a feasible, palliative method for unresectable malignant biliary obstruction. The clinical efficacy of EMS in patients with proximal hilar tumors is better than that in patients with distal tumors.
比较自膨式金属支架（EMS）治疗恶性胆管肿瘤远近端狭窄的疗效。
回顾性分析1995年3月至2004年6月期间61例接受自膨式金属支架植入术的恶性胆管梗阻患者（男40例，女21例）。支架通过内镜或经皮肝穿刺方法置入。对于肝门部肿瘤合并双侧肝管梗阻的病例，我们尝试在胆管系统中以T形或Y形放置两个支架。研究终点为支架闭塞或患者死亡。
近端狭窄组（I组）支架通畅的平均时间为421±67天，远端狭窄组（II组）为168±18天。两组之间的差异在临界值上具有统计学意义（P = 0.0567）。I组的平均生存时间为574±76天，II组为182±25天。两组之间存在显著差异（P = 0.0005）。
EMS植入是治疗不可切除恶性胆管梗阻的一种可行的姑息方法。EMS对近端肝门部肿瘤患者的临床疗效优于远端肿瘤患者。
