Department of Radiology, UBE INDUSTRIES, LTD. Central Hospital, Ube, Yamaguchi, Japan.
Eur J Cancer Care (Engl). 2013 Nov;22(6):782-8. doi: 10.1111/ecc.12088. Epub 2013 Jul 8.
To evaluate clinical safety and efficacy of percutaneous transhepatic hybrid biliary prostheses for palliative treatment in patients with common bile duct obstruction caused by advanced malignancies. A total of 13 consecutive patients was treated with percutaneous transhepatic biliary endoprostheses concurrently using both plastic and metallic stents. Serum total bilirubin levels before and after stent placement were evaluated. The technical success rate, the period with no obstructive jaundice, patient survival and complications were also assessed. Median bilirubin levels decreased from 3.8 mg/dL before to 1.2 mg/dL after stent placement, and this difference was statistically significant. The median no-jaundice period after bile duct stent placement was 6.0 months (range: 2-11 months), and overall survival time was 7.0 months. Of the 13 patients, nine did not have recurrent jaundice by the time of death, whereas four (31%) had recurrent jaundice. A second intervention was performed in these four patients. A new plastic stent was placed and jaundice did not recur up to the time of death. No serious complications such as cholangitis, pancreatitis or bile duct perforation developed. Percutaneous transhepatic hybrid biliary endoprostheses using both plastic and metallic stents can be useful as non-invasive palliative treatment to relieve jaundice in patients with malignant obstructive jaundice.
为了评估经皮经肝胆道杂交支架姑息治疗晚期恶性肿瘤所致胆总管梗阻患者的临床安全性和疗效。我们对 13 例连续患者同时使用塑料和金属支架进行经皮经肝胆道内支架置入术。评估支架置入前后血清总胆红素水平。还评估了技术成功率、无梗阻性黄疸期、患者生存和并发症。支架置入前中位胆红素水平为 3.8mg/dL，支架置入后降至 1.2mg/dL，差异有统计学意义。胆管支架置入后无黄疸期的中位时间为 6.0 个月（范围：2-11 个月），总生存时间为 7.0 个月。在 13 例患者中，9 例在死亡时未出现复发性黄疸，而 4 例（31%）出现复发性黄疸。这 4 例患者进行了第二次介入治疗。放置了新的塑料支架，直至死亡时未再出现黄疸。未发生严重并发症，如胆管炎、胰腺炎或胆管穿孔。经皮经肝胆道杂交内支架置入术同时使用塑料和金属支架，可作为恶性梗阻性黄疸患者非侵入性姑息治疗缓解黄疸的有效方法。
