Magistrelli P, Masetti R, Coppola R, Coco C, Antinori A, Nuzzo G, Picciocchi A
Department of General Surgery I, Catholic University of Rome, Italy.
J Surg Oncol Suppl. 1993;3:151-3. doi: 10.1002/jso.2930530539.
The majority of patients with malignant hilar obstruction have an unresectable tumor. Thus an effective palliation of obstructive jaundice is the main therapeutic goal and can be achieved by either surgical or non-surgical procedures. One hundred twenty-nine consecutive patients with proximal biliary stricture, admitted to our institution, were retrospectively reviewed. Thirty patients underwent surgical bypass, with 30-day mortality and morbidity rates of 10% and 23%, respectively. Median survival time was 41 weeks. Twenty-six patients were treated by percutaneous stenting, with 30-day mortality and morbidity rates of 15% and 19%, respectively. Median survival time was 19 weeks. Endoscopic palliation was performed in 73 patients, with 30-day mortality and morbidity rates of 5% and 18%, respectively. Median survival time was 27 weeks. Although the differences among the three groups of patients were not statistically significant, a lower morbidity rate in patients treated by endoscopic stenting was shown.
大多数恶性肝门部梗阻患者的肿瘤无法切除。因此，有效缓解梗阻性黄疸是主要治疗目标，可通过手术或非手术方法实现。对我院收治的129例连续性近端胆管狭窄患者进行了回顾性研究。30例患者接受了手术旁路治疗，30天死亡率和发病率分别为10%和23%。中位生存时间为41周。26例患者接受了经皮支架置入治疗，30天死亡率和发病率分别为15%和19%。中位生存时间为19周。73例患者接受了内镜下姑息治疗，30天死亡率和发病率分别为5%和18%。中位生存时间为27周。虽然三组患者之间的差异无统计学意义，但内镜下支架置入治疗的患者发病率较低。
