Bickerstaff K I, Berry A R, Chapman R W, Britton B J
Department of Surgery, John Radcliffe Hospital, Headington, Oxford, UK.
Br J Surg. 1990 Feb;77(2):160-2. doi: 10.1002/bjs.1800770215.
Palliative endoscopic sphincterotomy was performed on 17 patients with adenocarcinoma of the ampulla of Vater. An endoprosthesis was inserted immediately after the sphincterotomy in four of the patients. Fourteen patients made uncomplicated recoveries from the procedure and their jaundice resolved completely. Early complications developed in three patients. One patient died from haemorrhage. Two patients, both of whom had an endoprosthesis, developed cholangitis. The endoprosthesis was removed and another inserted in one patient and the other underwent surgery. Both thereafter made uncomplicated recoveries. Jaundice subsequently recurred in eight patients and further endoscopic treatment was successful in five of these patients. Eleven patients died between 4 days and 23 months after the sphincterotomy with a median survival of 12 months. Four patients remain alive between 3 and 17 months after treatment. The results indicate that reasonable palliation can be achieved safely by endoscopic sphincterotomy.
对17例壶腹腺癌患者实施了姑息性内镜括约肌切开术。其中4例患者在括约肌切开术后立即置入了内支架。14例患者术后恢复顺利，黄疸完全消退。3例患者出现早期并发症。1例患者死于出血。2例置入内支架的患者发生了胆管炎。其中1例患者取出原内支架并重新置入，另1例接受了手术治疗。此后两人均恢复顺利。8例患者黄疸复发，其中5例经进一步内镜治疗取得成功。11例患者在括约肌切开术后4天至23个月内死亡，中位生存期为12个月。4例患者在治疗后3至17个月仍存活。结果表明，内镜括约肌切开术可安全地实现合理的姑息治疗。
