Savader S J, Cameron J L, Pitt H A, Venbrux A C, Trerotola S O, Chen M C, Lund G B, Mitchell S E, Osterman F A
Department of Radiology, Johns Hopkins Hospital, Baltimore, MD 21287.
J Vasc Interv Radiol. 1994 Sep-Oct;5(5):757-63. doi: 10.1016/s1051-0443(94)71597-9.
To evaluate the biliary manometric-perfusion test (BMPT) and clinical trial as predictors of long-term success after percutaneous and surgical treatment of biliary tract strictures.
After percutaneous intervention or surgical repair of extrahepatic bile duct strictures, 43 patients underwent long-term biliary intubation (mean, 13 months) with 61 internal-external stents. Before removal of the stents, all 43 patients underwent a BMPT (n = 65) and 24 underwent a 2-3-week clinical trial (n = 27) with stents positioned above the treated region. Patients were followed up 1-46 months (mean, 16 months) after stent removal, with clinical outcome determined by means of physical examination, biochemical evaluation, chart review, and telephone interview.
With logistic regression analysis, the BMPT and clinical trial were shown to have equal predictive value in determining treatment success or failure. Eighty-four percent of the clinical outcomes were correctly predicted with BMPT, versus 88% for the clinical trial. Kaplan-Meier survival curve analysis demonstrated the probability of remaining stricture free at 1 year after passing a BMPT and after passing a clinical trial to be 90% and 86% (P = .55), respectively.
BMPT and clinical trial have similar capabilities in the prediction of long-term patency after treatment of benign biliary tract strictures, but the BMPT is less costly and time consuming for the patient.
评估胆道测压灌注试验（BMPT）及临床试验对经皮和手术治疗胆道狭窄后长期疗效的预测价值。
对肝外胆管狭窄进行经皮介入或手术修复后，43例患者使用61根内外支架进行了长期胆道插管（平均13个月）。在移除支架前，所有43例患者均接受了BMPT（n = 65），24例患者在治疗区域上方放置支架进行了为期2 - 3周的临床试验（n = 27）。在移除支架后对患者进行了1 - 46个月（平均16个月）的随访，通过体格检查、生化评估、病历审查和电话访谈确定临床结局。
通过逻辑回归分析，BMPT和临床试验在确定治疗成功或失败方面具有同等的预测价值。BMPT对84%的临床结局预测正确，而临床试验为88%。Kaplan-Meier生存曲线分析表明，通过BMPT和通过临床试验后1年无狭窄的概率分别为90%和86%（P = 0.55）。
BMPT和临床试验在预测良性胆道狭窄治疗后的长期通畅方面具有相似的能力，但BMPT对患者来说成本更低且耗时更少。
