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经皮经肝胆道引流术

[Percutaneous transhepatic biliary drainage].

作者信息

Nicoli N, Petronio R, Marzoli G P, Serio G, Pulica C, Mangiante G

出版信息

Chir Ital. 1978 Oct;30(5):439-55.

PMID:699220
Abstract

The authors describe their experience in 23 cases of biliary tract drainage by the transhepatic-percutaneous approach in the course of obstructive jaundice of diversified origin. This can be done for essentially three reasons, namely to alleviate jaundice preoperatively, to provide permanent bile drainage in patients not amenable to surgery, and to relieve excess pressure in surgical anastomoses of the biliary passages. On the basis of biological considerations (relationship between severity and duration of cholestasis on the one hand and postoperative mortality and morbidity on the other), and in light of their own results, the authors argue in favor of this procedure, explaining that it is only mildly traumatic to the patient, easy to perform, attended by a low quota of complications, and above all effective as a drainage; also, it does not unduly prolong the preoperative period for patients scheduled for further and major surgery. Also in view of the current role of PTC in the diagnosis of obstructive jaundice, they submit that transhepatic-percutaneous drainage should be done right next to recognition of dilatation of the intrahepatic bile passages by CAT or echotomography.

摘要

作者描述了他们在23例因各种原因引起的梗阻性黄疸患者中采用经皮经肝途径进行胆道引流的经验。进行这种操作主要有三个原因,即术前减轻黄疸、为不宜手术的患者提供永久性胆汁引流以及减轻胆道手术吻合处的过高压力。基于生物学考量(一方面是胆汁淤积的严重程度和持续时间与术后死亡率和发病率之间的关系),并结合他们自己的结果,作者支持这一操作,解释说该操作对患者的创伤较小,易于实施,并发症发生率低,最重要的是作为一种引流方法很有效;此外,对于计划进行进一步大型手术的患者,它不会过度延长术前时间。鉴于目前经皮肝穿刺胆管造影(PTC)在梗阻性黄疸诊断中的作用,他们认为在通过计算机断层扫描(CAT)或超声断层扫描识别肝内胆管扩张后应立即进行经皮经肝引流。

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