Tsang T K, Crampton A R, Bernstein J R, Ramos S R, Wieland J M
Ann Intern Med. 1987 Mar;106(3):389-92. doi: 10.7326/0003-4819-106-3-389.
The placement of large-bore endoprostheses for relief of biliary obstruction by the percutaneous-transhepatic route is painful, requires a large hepatic parenchymal tract, and has a fairly high complication rate. The alternative technique of endoscopically placing similar-sized stents requires special instruments and skills, and may fail in passing very tight stenoses. We report a simpler combined percutaneous-endoscopic biliary stent (PEBS) placement technique with a high placement rate used in 11 patients with advanced malignant obstruction. In all 11 patients, 10 and 11.5 French stents were easily placed. Three patients developed sepsis but responded to antibiotics. One clogged stent required replacement. Two stents needed later endoscopic adjustment. Results of liver function test improved in 10 patients, and 8 patients showed improved quality of life.
经皮经肝途径放置大口径内支架以缓解胆道梗阻会引起疼痛，需要建立较大的肝实质通道，且并发症发生率相当高。通过内镜放置尺寸相近的支架这一替代技术需要特殊器械和技能，并且在通过非常狭窄的狭窄段时可能失败。我们报告了一种更简单的经皮 - 内镜联合胆道支架（PEBS）放置技术，该技术放置成功率高，应用于11例晚期恶性梗阻患者。在所有11例患者中，轻松放置了10和11.5法式支架。3例患者发生败血症，但对抗生素治疗有反应。1例堵塞的支架需要更换。2个支架后来需要内镜调整。10例患者肝功能测试结果改善，8例患者生活质量提高。
