Rieber A, Görich J, Friedrich J M, Vogel J, Brambs H J
Abteilung für Röntgendiagnostik, Radiologische Universitätsklinik Ulm, Deutschland.
Bildgebung. 1996 Jun;63(2):83-8.
Surgical treatment of benign bile duct strictures continues to be associated with significant lethality. Thus, radiological interventions become increasingly important. A total of 32 patients were treated. Their bile duct strictures had different origins. We performed percutaneous transhepatic cholangiographies in 32 patients, cholangioscopies in 7, and biopsies in 2 patients. Therapeutic interventions included percutaneous transhepatic drainages in 30 patients, laser lithotripsies in 5, and dilatations in 8 patients. As a total, 36 stents (mostly Palmaz stents) were implanted in 27 patients. Acuflex stents were implanted in 2 of these patients and were extracted after successful clearance of the bile ducts following stone fragmentation. No severe complications were observed. Five out of 8 dilatations were unsuccessful, so that stents were implanted. Five patients died. Three stent occlusions and 1 spontaneous stent migration occurred after an average of 29 months; the latter could be treated by means of radiological procedures. The remaining patients are living symptom-free, on average, since 18.6 months.
良性胆管狭窄的外科治疗仍然伴随着较高的致死率。因此，放射介入治疗变得越发重要。共有32例患者接受了治疗。他们的胆管狭窄病因各异。我们对32例患者进行了经皮肝穿刺胆管造影，7例进行了胆管镜检查，2例进行了活检。治疗干预措施包括30例患者接受了经皮肝穿刺引流，5例接受了激光碎石术，8例接受了扩张术。总共27例患者植入了36枚支架（多数为帕尔马支架）。其中2例患者植入了Acuflex支架，在结石破碎后胆管成功疏通后将其取出。未观察到严重并发症。8例扩张术中5例未成功，因此植入了支架。5例患者死亡。平均29个月后发生了3例支架堵塞和1例支架自发移位；后者可通过放射学方法进行治疗。其余患者平均自治疗后18.6个月起无任何症状。
