Pereiras R V, Rheingold O J, Huston D, Mejia J, Viamonte M, Chiprut R O, Schiff E R
Ann Intern Med. 1978 Nov;89(5 Pt 1):589-3. doi: 10.7326/0003-4819-89-5-589.
Twelve patients with malignant obstruction of the biliary tree were treated by dilating the lesion percutaneously and inserting an internal large-bore teflon prosthesis in place bridging the the stricture. All 12 patients had unresectable neoplasms. The procedure was devised because existing modes of palliation using surgical techniques are associated with significant mortality or mobidity. There are also many problems with nonsurgical catheter drainage. Decompression was achieved in all 12 patients as shown radiographically by passage of contrast into the duodenum. Disappearance of pruitus was achieved in seven of seven patients, and in 10 of 12 disappearance of jaundice (bilirubin, before prosthesis, 18.4 +/- 4.5 mg/dl [mean +/- 1 SD], bilirubin 1 month after prosthesis, 1.8 +/- 0.6 mg/dl [mean +/- 1 SD], P less than 0.001) with improvement of general clinical status was achieved. Percutaneous placement of a permanent biliary tract prosthesis is safe and effective for the palliative decompression of malignant biliary tract obstruction.
12例胆道恶性梗阻患者接受了经皮扩张病变部位并置入大口径聚四氟乙烯内支架以跨越狭窄部位的治疗。所有12例患者均患有无法切除的肿瘤。设计该手术是因为现有的采用外科技术的姑息治疗方式伴有显著的死亡率或发病率。非手术导管引流也存在许多问题。所有12例患者均实现了减压，造影显示对比剂进入十二指肠。7例瘙痒患者中有7例瘙痒消失，12例患者中有10例黄疸消失（放置支架前胆红素为18.4±4.5mg/dl[均值±1标准差]，放置支架1个月后胆红素为1.8±0.6mg/dl[均值±1标准差]，P<0.001），且总体临床状况得到改善。经皮放置永久性胆道支架对恶性胆道梗阻的姑息性减压是安全有效的。
