Men S, Hekimoglu B, Kaderoglu H, Pinar A, Conkbayir I, Soylu S O, Bulut A, Yandakçi K, Baran I, Aran Y
Department of Radiology, Social Security Hospital, Ankara, Turkey.
Acta Radiol. 1996 May;37(3 Pt 1):259-66. doi: 10.1177/02841851960371P158.
The aim of this study was to analyze the clinical efficacy of metal stents in the palliation of malignant obstructive jaundice.
Fifty patients with malignant biliary obstruction were palliated by means of drainage with a metallic self-expandable stent (Wallstent). Nineteen patients had pancreatic carcinoma, 22 cholangiocarcinoma, 4 hepatocellular carcinoma, and the remaining 5 metastatic carcinoma from a variety of primary sites. The obstruction was at the level of the liver hilum in 19 cases, in the middle common bile duct in 11, and in the lower common bile duct in 20.
The patients were followed over a period of 1-17 months. A total of 36 patients (72%) died; 14 (28%) survived. The mean observation time for the whole group of 50 patients was 3.3 months. The 30-day mortality rate was 14% (7 patients). Short-term complications occurred in 6 patients (12%). Long-term complications included stent occlusion requiring a 2nd intervention in 2 patients (4%), and cholangitis in 2 patients (4%). Excellent palliation was achieved in most of the patients. No stent migration was observed.
The metallic stent provides good palliative drainage, and the percutaneous insertion of metallic stents is well tolerated by the patients. The procedure is simple and safe to use and can be executed in one stage. The one-stage procedure, compared to the 2-stage procedure, may reduce hospital stays.
本研究旨在分析金属支架缓解恶性梗阻性黄疸的临床疗效。
50例恶性胆管梗阻患者采用金属自膨式支架（Wallstent）引流进行姑息治疗。19例为胰腺癌，22例为胆管癌，4例为肝细胞癌，其余5例为来自各种原发部位的转移癌。梗阻位于肝门部19例，胆总管中部11例，胆总管下部20例。
对患者进行了1至17个月的随访。共有36例患者（72%）死亡；14例（28%）存活。50例患者的平均观察时间为3.3个月。30天死亡率为14%（7例）。6例患者（12%）出现短期并发症。长期并发症包括2例患者（4%）需要再次干预的支架阻塞，以及2例患者（4%）的胆管炎。大多数患者实现了良好的姑息治疗。未观察到支架移位。
金属支架提供了良好的姑息性引流，患者对经皮插入金属支架耐受性良好。该操作简单安全，可一次性完成。与两阶段操作相比，一次性操作可能会缩短住院时间。
