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目的探讨记忆合金胆道支架置入在不能切除的肝门区胆管癌手术中的可行性和临床应用价值。方法1998年1月~2006年1月,我院对17例术中发现无法根治切除的晚期肝门部胆管癌,经胆总管切开置入记忆合金支架扩张闭塞或狭窄的胆管,完成胆汁内引流。结果17例放置支架术后2周内黄疸消退,经引流管造影显示胆道梗阻解除。16例随访4~30个月,平均11.5月,13例死亡(生存期4~20个月,平均11个月),3例分别已经存活10、12·5、30个月。结论对术中发现无法根治切除的肝门区胆管癌患者,记忆合金胆道支架置入术操作简单,能有效解除梗阻性黄疸,是一种较好的姑息治疗方法。
Objective To investigate the feasibility and clinical value of memory alloy biliary stenting in unresectable hilar cholangiocarcinoma. Methods From January 1998 to January 2006, 17 patients with advanced hilar cholangiocarcinoma who could not be treated by radical resection were treated in our hospital from January 1998 to January 2006. The patients underwent choledocholithotomy and dilated occlusion or stenosis bile duct with memory alloy stent to complete bile duct drainage. Results 17 cases of stent placement within 2 weeks after the jaundice subsided, the drainage tube angiography showed biliary obstruction was relieved. Sixteen patients were followed up for 4 to 30 months, with an average of 11.5 months. Thirteen patients died (survival time was 4-20 months, an average of 11 months). Three patients survived 10, 12.5, and 30 months respectively. Conclusion It is a good palliative treatment for patients with hilar cholangiocarcinoma who can not be treated by radical resection. The operation of the memory alloy biliary stenting is simple and can effectively relieve obstructive jaundice.