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目的：研究经皮胆道内支架置入术姑息性治疗恶性梗阻性黄疸的临床价值。材料与方法：５１例恶性梗阻性黄疸患者，在经皮胆道造影后进行了胆道内支架置入。其中置入塑料内支架者９例，自展式金属内支架者４２例，共使用胆道内支架５６枚。结果：全组治疗前、后血清总胆红素相差的均数±标准误为１６７±５２μｍｏｌ／Ｌ，Ｐ＜０．００５。５１例中，总胆红素恢复正常或接近正常者３６例，总胆红素下降百分比＞５０％者８例，下降百分比为２５％～５０％者４例，下降百分比＜２５％者３例。全组３０天病死率５．９％（３／５１），早期并发症１９．６％（１０／５１）。２６例有完整随访的患者（平均５．６个月），死亡１１例（４２．３％），内支架阻塞４例（１５．４％），其中３例进行了再次介入治疗。结论：经皮胆道内支架置入术是姑息性治疗手术不能切除的恶性梗阻性黄疸的有效方法。
Objective: To study the clinical value of percutaneous biliary stenting for palliative treatment of malignant obstructive jaundice. Materials and Methods: In 51 patients with malignant obstructive jaundice, biliary stenting was performed after percutaneous cholangiography. Among them, 9 were plastic stents and 42 self-expanding metal stents. A total of 56 biliary stents were used. Results: The mean±standard error of serum total bilirubin difference before and after treatment in the whole group was 167±52 μmol/L, P<0.005. Of the 51 patients, 36 had normal or almost normal total bilirubin. The percentage of total bilirubin decreased by more than 50% was found in 8 cases, and the percentage of decline was 25% to 50% in 4 cases, and the percentage of decrease was <25% in 3 cases. The 30-day mortality rate for the whole group was 5.9% (3/51), and the early complication was 19.6% (10/51). Of the 26 patients who had complete follow-up (mean 5.6 months), 11 (42.3%) died and 4 (15.4%) had internal stent obstruction, and 3 of them had reintervention. Conclusion: Percutaneous biliary stenting is an effective method for palliative treatment of malignant obstructive jaundice that cannot be removed by surgery.