Kaskarelis I S, Minardos I A, Abatzis P P, Malagari K S, Vrachliotis T G, Natsika M K, Kouris S G, Roubis K G, Vrachliotis G T
Department of Radiology, Regional General Hospital of Athens: Evangelismos, Greece.
Hepatogastroenterology. 1996 Jul-Aug;43(10):785-91.
BACKGROUND/AIMS: Up to now, all reports about metallic stents concerned mostly patients with obstructive jaundice due to primary cancer although some of these series included a small number of patients with metastatic disease as a cause of occlusion of the bile ducts. The question of whether they should be used in patients with biliary obstruction due to metastatic disease, and consequently have a limited life expectancy, is investigated.
Between January 1994 and April 1995, we inserted percutaneously 20 metallic self-expandable endoprostheses in 14 patients with obstructive jaundice due to metastatic disease.
Twelve patients died with a mean survival of 144.6 (range 25-338) days without any evidence of biliary reobstruction. For 2 patients, we have followup no longer than 30 days. Thirty day mortality was 7.2% (1/14). Jaundice reoccurred in one patient but wasn't related to stent obstruction, and he died during the first 30 days. We had 2 cases with moderate hemobilia.
We believe that the use of metal stents in patients with obstructive jaundice due to metastatic disease is justified. Their high initial cost is offset by their prolong patency, decreased complication rate and shorter hospitalization.
背景/目的：到目前为止，所有关于金属支架的报告主要涉及原发性癌症导致梗阻性黄疸的患者，尽管其中一些系列纳入了少数因转移性疾病导致胆管阻塞的患者。本研究探讨了对于预期寿命有限、因转移性疾病导致胆道梗阻的患者是否应使用金属支架。
1994年1月至1995年4月期间，我们为14例因转移性疾病导致梗阻性黄疸的患者经皮植入了20个金属自膨式内支架。
12例患者死亡，平均生存期为144.6天（范围25 - 338天），无胆道再梗阻迹象。2例患者随访时间不超过30天。30天死亡率为7.2%（1/14）。1例患者黄疸复发，但与支架阻塞无关，该患者在最初30天内死亡。我们有2例中度胆道出血。
我们认为，对于因转移性疾病导致梗阻性黄疸的患者，使用金属支架是合理的。其高昂的初始成本因支架通畅时间延长、并发症发生率降低及住院时间缩短而得到弥补。
