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为缓解胆道梗阻，对２８例恶性胆道梗阻（ＭＢＯ）患者行经内镜胆管内引流术（ＥＢＤ）。结果２５例（８９％）插管成功，共插管４４次，７Ｆ管３次，１０Ｆ２５次，１２Ｆ１６次。２３例（９２％）减黄有效，ＥＢＤ后第３天胆红素平均下降４６．３％，肝外胆管径平均回缩５８．６％，减黄有效者腹胀迅速消失或减轻。首次插管维持有效引流时间１４１．５±１５１．２天，早、中期并发胆管炎４０％，１年以上生存１７％。结果表明ＥＢＤ减黄效果和症状改善是显著的，胆红素下降与胆管径回缩相平行。认为胆管是否屈曲及乳头括约肌切开术的好坏是ＥＢＤ成败的关键；腹胀再现，有胆道感染症状及Ｂ超见肝外胆管扩张为通管的指征。ＥＢＤ适合高龄或高危人群的ＭＢＯ患者，对延长生存期有重要的价值。
To relieve biliary obstruction, endoscopic biliary drainage (EBD) was performed in 28 patients with malignant biliary obstruction (MBO). Results Twenty-five patients (89%) were successfully intubated, with a total of 44 intubations, 7F tubes 3 times, 10F 25 and 12F 16. 23 cases (92%) were effective in reducing yellowing. After the first 3 days of EBD, bilirubin decreased by an average of 46.3%, and the extrahepatic bile duct diameter retracted by 58.6%. The diarrhea in the effective yellow reducing group quickly disappeared or decreased. The first intubation maintained an effective drainage time of 141.5±151.2 days. In the early and mid-term, 40% of cholangitis was complicated and 17% of patients survived for more than 1 year. The results showed that the yellowing effect and symptoms of EBD were significantly improved. The decrease of bilirubin was parallel to the retraction of biliary diameter. Whether the bile duct is flexed or whether the sphincterotomy is good or not is the key to the success or failure of EBD; bloating reappears, there are symptoms of biliary tract infections, and B-scan sees the indication of extrahepatic bile duct dilation as a guide. EBD is suitable for MBO patients with advanced age or high risk. It is of great value for prolonging survival.