【摘要】 目的 探讨金属内支架置入术在老年人恶性胆道梗阻中的临床应用价值。 方法 采用细针经皮经肝胆道穿刺法，一次金属支架置入法。 结果 27例中22例置入金属内支架，穿刺成功率100%，患者在1～3周后，总胆红素平均下降130μmol/L，直接胆红素平均下降110 μmol/L，12例生存6～18个月(平均10.5个月)后死亡，10例生存3周～15个月，现健在；5例行胆道内外引流，生存3周～3个月(平均2.6个月)。并发症:支架再梗阻3例，2例行再介入治疗；术中操作引起并发症3例。 结论 金属内支架置入术更适合年老体弱患者,可以替代外科姑息手术方法。

Application of metallic stents for malignantbiliary obstruction in the elderly

ZHANG Yongchun,YU Jingying,Wu Qiong, etal.Department of Radiology, Beijing Hospital,Beijing 100730

【Abstract】 Objective To evaluate theclinical application of metallic stents for malignant biliary obstruction in the elderly. Methods Implantationof metallic stents was carried out right after percutanous transhepatic andtranscholedochal puncture with fine needle. Results The operationwas successful in all the 22 patients,of whom 12 died 6 to 18 months (mean 10.5 months)after the operation and 10 survived from 3 weeks to 15 months.Five patients were treatedby percutaneous transhepatic bile drainage because of financial problem and the survivalperiod was shorter,being 3 weeks to 3 months(mean 2.6 months).Jaundice recurred 9 monthsafter the operation in 3 patients and 2 were recanalized. Conclusions Implantationof metallic stents after percutaneous transhepatic and transcholedochal puncture with fineneedle is feasible as a palliative treatment for malignant biliary obstruction in theelderly and is more acceptable than surgery in elderly patients.

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