Rossi P, Pavone P, Maradei A, Castrucci M, Maccioni F, Santoro P
Cattedra di Radiologia Generale e Speciale Odontostomatologica, Università, Milano.
Radiol Med. 1988 Oct;76(4):303-7.
For the decompression of the biliary tree in case of obstructive neoplastic jaundice, 62 biliary endoprostheses were placed in 54 patients as an alternative to internal-external drainage. Teflon prostheses were used in 26 patients--which were placed in the stenotic tract--while in 28 patients soft percuflex prostheses were used, whose lower extremity was placed in the duodenum. The mean survival has been 6-7 months, with peaks ranging from 1 month to 2 years. By comparing the results obtained with the two different kinds of prosthesis we found that soft endoprostheses were associated with a lower incidence of late complications than teflon prostheses: cholangitis occurred in 7.2% of cases (vs teflon: 16%), occlusions in 3.5% (vs teflon: 11.5%), migrations in 7.2% (vs teflon: 7.6%). The incidence of such complications was, however, higher a few months after the application of the prosthesis. This palliative treatment is suggested in patients whose expected survival is not longer than 1-6 months. On the contrary, in case of patients with a better prognosis, an internal-external catheter drainage is preferred, for an easier access to the site of the lesion.
对于梗阻性肿瘤性黄疸患者的胆管减压，54例患者共置入62个胆管内支架作为内外引流的替代方法。26例患者使用了置于狭窄段的聚四氟乙烯支架，28例患者使用了下端置于十二指肠的软质percuflex支架。平均生存期为6至7个月，峰值为1个月至2年。通过比较两种不同类型支架的结果，我们发现软质内支架与聚四氟乙烯支架相比，晚期并发症的发生率更低：胆管炎发生率为7.2%（聚四氟乙烯支架为16%），堵塞发生率为3.5%（聚四氟乙烯支架为11.5%），移位发生率为7.2%（聚四氟乙烯支架为7.6%）。然而，这些并发症的发生率在置入支架几个月后更高。对于预期生存期不超过1至6个月的患者，建议采用这种姑息治疗。相反，对于预后较好的患者，首选内外置管引流，以便更易于接近病变部位。
