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目的分析胰胆管内支架引流疗效,探讨影响因素与提高疗效手段。方法回顾性分析治疗随访资料。结果 1995-02/1999-03采用塑料、金属胆道支架,塑料胰管支架经内镜主乳头置入胰胆管引流良恶性胰胆管梗阻148例,其中男83例,女65例,平均57.1岁。塑料胆道支架组:成功率94.7％,良、恶性梗阻引流有效率分别为89.3％与79.3％(P<0.05)。金属胆道支架与塑料胰管支架组:成功率与有效率均为100％。术后早期并发症包括:高淀粉酶血症,轻度ERCP术后胰腺炎、术后早期胆管炎,无严重相关并发症与相关死亡发生。结论胰胆管梗阻内置管引流术是一种安全有效的治疗手段,合理选择病例,采用不同手段力求导丝通过狭窄、双支架引流等方法可改善疗效。
Objective To analyze the curative effect of pancreaticobiliary duct drainage and to explore the influencing factors and ways to improve curative effect. Methods Retrospective analysis of treatment follow-up data. Results Between February 1995 and March 1999, 148 cases of benign and malignant cholangiopancreatography were treated with plastic and metallic biliary stents and plastic pancreatic duct stents via endoscopic primary papilla. There were 83 males and 65 females, with an average of 57.1 years. Plastic biliary stent group: the success rate of 94.7%, good and malignant obstruction drainage efficiency were 89.3% and 79.3% (P <0.05). Metal biliary stent and plastic pancreatic stent group: the success rate and efficiency are 100%. Early postoperative complications include: hyper amylase, mild post-ERCP pancreatitis, early postoperative cholangitis, no serious complications and related deaths. Conclusions Dilatation of pancreaticobiliary duct obstruction is a safe and effective treatment, and the reasonable choice of cases, using different means to guide the wire through the stenosis, double stent drainage and other methods can improve the curative effect.