Murai R, Hashiguchi F, Kusuyama A, Yoshimi M, Watanabe K, Okui S, Ando H, Itsubo K
Department of Surgery, Daisan Hospital, Jikei University School of Medicine, Tokyo, Japan.
Surg Endosc. 1991;5(3):140-2. doi: 10.1007/BF02653221.
Percutaneous stenting for malignant biliary stenosis is quite beneficial to patients with unresectable or recurrent disease, tremendously improving the quality of their lives. Percutaneous transhepatic biliary drainage (PTBD) was attempted in 92 patients with obstructive jaundice during the period between January 1986 and July 1989. Implantation of an endoprosthesis was performed in 14 cases (15.2%) and succeeded in 12 (85.7%). When a guide wire could not be passed distally across the stricture site, percutaneous transhepatic cholangioscopy (PTCS) through the dilated PTBD fistula was carried out to enable its passage. PTCS is also valuable in the preoperative diagnosis of obstructive jaundice. The patients who are not candidates for surgery are suitable for this procedure. A Miller double-mushroom stent is used as the endoprosthesis in the majority of cases. One patient with recurrent hepatoma has lived at home with this stent for greater than 3 years due to repeated transarterial embolization and chemotherapy and does not need to wash or change the stent.
经皮支架置入术治疗恶性胆管狭窄对无法切除或复发疾病的患者非常有益，极大地改善了他们的生活质量。1986年1月至1989年7月期间，对92例梗阻性黄疸患者尝试了经皮经肝胆道引流（PTBD）。14例（15.2%）患者进行了内置假体植入，其中12例（85.7%）成功。当导丝无法向远端穿过狭窄部位时，通过扩张的PTBD瘘道进行经皮经肝胆道镜检查（PTCS）以使其通过。PTCS在梗阻性黄疸的术前诊断中也很有价值。不适合手术的患者适合此手术。大多数情况下使用米勒双蘑菇支架作为内置假体。一名复发性肝癌患者因反复经动脉栓塞化疗，使用该支架在家中生活了3年多，无需冲洗或更换支架。
