Percutaneous transhepatic biliary drainage in patients with malignant biliary obstruction of the hepatic confluence.
Percutaneous transhepatic biliary drainage in patients with malignant biliary obstruction of the hepatic confluence.
复制标题
经皮肝穿刺胆道引流术治疗肝交汇处恶性胆道梗阻的患者。
作者：
Masato Nagino;N. Hayakawa;Y. Nimura;Mitsuru Dohke;S. Kitagawa
尽管有许多关于经皮经肝胆管胆道引流（PTBD）的研究，但PTBD治疗肝汇合部恶性梗阻的报道尚不令人满意。在这项研究中，结果PTBD使用的直接前的方法在透视下的指导下，在16例恶性胆道梗阻的肝汇合。16名患者共置入42根引流导管：3名患者置入1根导管; 6名患者置入2根导管; 4名患者置入3根导管; 2名患者置入4根导管; 1名患者置入7根导管。PTBD成功率100%，无死亡及严重并发症，胆道减压效果满意。9例患者接受了组织学治愈性肝切除术。9例中2例术后死于肝功能衰竭，其余患者术后恢复良好。作者强调，对于肝汇合部的晚期恶性梗阻，必须对每一个孤立的节段性胆管进行选择性胆道引流。
Despite many studies on percutaneous transhepatic biliary drainage (PTBD), there are no satisfactory reports of PTBD for malignant obstruction of the hepatic confluence. In this study, the results of PTBD using the direct anterior approach under fluoroscopic guidance are described in 16 patients with malignant biliary obstruction of the hepatic confluence. A total of forty-two drainage catheters were placed in the 16 patients: one catheter was placed in three patients; two catheters in six; three catheters in four; four catheters in two; seven catheters in one. PTBD was successful in 100% of the cases with no mortality or critical complications, and the biliary decompression effect of PTBD was highly satisfactory. Nine patients underwent histologically curative hepatectomies. Two of the nine resected cases died of postoperative hepatic failure, but the postoperative course in the others was satisfactory. The authors stress that selective biliary drainage for each isolated segmental duct is mandatory for advanced malignant obstruction of the hepatic confluence.