| 陈尘,高健,郅新,洪楠.对比观察交叉支架与Y型支架用于治疗Ⅳ型肝门部胆管癌致梗阻性黄疸[J].中国医学影像技术,2023,39(10):1531~1535 |
| 对比观察交叉支架与Y型支架用于治疗Ⅳ型肝门部胆管癌致梗阻性黄疸 |
| Comparison on crisscross- and Y-stent implantation for treating obstructive jaundice caused by type Ⅳ hilar cholangiocarcinoma |
| 投稿时间：2023-07-04 修订日期：2023-08-28 |
| DOI：10.13929/j.issn.1003-3289.2023.10.018 |
| 中文关键词: 胆管肿瘤 黄疸 支架 |
| 英文关键词:bile duct neoplasms jaundice stents |
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| 中文摘要: |
| 目的 对比观察交叉支架与Y型支架用于治疗Ⅳ型肝门部胆管癌(HCCA)致梗阻性黄疸的效果。方法 对53例Ⅳ型HCCA引发梗阻性黄疸患者行胆道支架植入术。其中,对交叉组(n=22)分别穿刺肝右前叶、右后叶肝内胆管(7例)或右后叶、左叶肝内胆管(15例)并交叉式植入支架;对Y型组(n=31)分别穿刺肝左、右叶肝内胆管以Y型植入支架;记录治疗用时,比较组间治疗前、治疗后30天血清总胆红素(TBIL)、直接胆红素(DBIL)及谷丙转氨酶(GPT)水平差异,以及上述各指标治疗前后的差值和下降率,观察治疗后1个月内并发症。结果 2组均顺利植入胆道支架,未出现不良反应或并发症。组间治疗前、治疗30天后TBIL、DBIL、GPT水平,以及治疗前后的差值及下降率差异均无统计学意义(P均＞0.05)。交叉组治疗用时长于Y型支架组(P=0.003)。结论 交叉式与Y型植入胆道支架均能有效缓解Ⅳ型HCCA所致梗阻性黄疸;交叉式植入支架术式较为复杂、耗时,但可避免经左侧肝内胆管穿刺入路。 |
| 英文摘要: |
| Objective To compare the effect of crisscross- and Y-stent implantation for treating obstructive jaundice caused by type Ⅳ hilar cholangiocarcinoma (HCCA). Methods Totally 53 patients with obstructive jaundice caused by type Ⅳ HCCA underwent biliary stent implantation. Puncture of intrahepatic bile ducts in the right anterior lobe and right posterior lobe (n=7), or in the right posterior lobe and left lobe (n=15) were performed in 22 cases in crisscross group, while puncture of intrahepatic bile ducts in the left and right lobe were performed in 31 patients in Y-stent group, respectively. The operation time was recorded. Serum total bilirubin (TBIL), direct bilirubin (DBIL), and glutamic-pyruvic transaminase (GPT) levels before and 30 days after operation were compared between groups, as well as the preoperative-postoperative differences and decrease rates of the above indicators. The complications within 1 month after stent implantation were observed. Results Biliary stents were successfully implanted in both groups, and no adverse reaction nor complication occurred. There was no significant difference of levels of TBIL, DBIL, GPT, preoperative-postoperative difference nor decrease rates before nor 30 days after operation between groups (all P＞0.05). The operative time of crisscross group was significantly longer than that of Y-stent group (P=0.003). Conclusion Both crisscross- and Y-stent implantation could effectively alleviate obstructive jaundice caused by type Ⅳ HCCA. Crisscross-stent implantation was more complex and time-consuming, but was helpful for avoiding puncture through intrahepatic bile duct in the left lobe. |
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