Neuhaus H, Hagenmüller F, Griebel M, Rotter M, Classen M
II. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München.
Dtsch Med Wochenschr. 1990 Aug 31;115(35):1299-306. doi: 10.1055/s-2008-1065157.
Self-expanding metal stents were implanted in 30 patients (14 men and 16 women, mean age 67 [40-86] years) with malignant (n = 27) or benign (n = 3) obstruction of the biliary tract (hepatic duct bifurcation: n = 14; choledochal duct: n = 16). The stents were introduced and left in place endoscopically in 13, percutaneously and transhepatically via a 7 or 9 F catheter in 17 patients. The stents, which expand to a diameter of 7-10 mm, in all cases achieved complete drainage, as confirmed by cholangiography. Jaundice completely disappeared in 28 of 30 patients. No complications were noted during a 30-day period of observation. After a median follow-up period of 90 days, 17 patients have been without jaundice for a median period of 141 (30-330) days. A recurrence of jaundice was noted in three patients (restenosis proximal to the stent in 2, incrustation with bile in one). Ten patients died, without any signs pointing to stent occlusion. These data indicate that the probability of stent patency in malignant stenoses of 200 days after implantation is 84%, so that stents in most cases provide a safe and effective means of drainage. Because they have a relatively large lumen with small surface area infection, occlusion and migration apparently occur less often than with conventional synthetic prostheses.
30例患者（14例男性，16例女性，平均年龄67岁[40 - 86岁]）植入了自膨式金属支架，这些患者存在恶性（n = 27）或良性（n = 3）胆道梗阻（肝门胆管分叉处梗阻：n = 14；胆总管梗阻：n = 16）。13例患者通过内镜引入并留置支架，17例患者经皮经肝通过7F或9F导管引入支架。支架扩张后直径达7 - 10mm，所有病例经胆管造影证实均实现了完全引流。30例患者中有28例黄疸完全消退。在30天的观察期内未发现并发症。中位随访90天后，17例患者无黄疸的中位时间为141天（30 - 330天）。3例患者出现黄疸复发（2例为支架近端再狭窄，1例为胆汁结痂）。10例患者死亡，无任何提示支架闭塞的迹象。这些数据表明，植入后200天恶性狭窄中支架通畅的概率为84%，因此在大多数情况下，支架提供了一种安全有效的引流方法。由于它们具有相对较大的管腔和较小的表面积，感染、闭塞和移位明显比传统合成假体少见。
