文献类型：期刊文献

中文题名：特殊条件下放置塑料支架在胆总管结石伴梗阻中的应用

英文题名：Putting Plastic Biliary tent to Cure Common Duct Stones Combined Obstruction in Specific Conditions

作者：曹卫鹏[1,2];施斌[3];陈岳祥[3]

第一作者：曹卫鹏

机构：[1]兰空机关医院;[2]甘肃中医学院,硕士研究生兰州730000;[3]第二军医大学附属长征医院,上海200003

第一机构：兰空机关医院

年份：2010

卷号：16

期号：1

起止页码：4

中文期刊名：河南外科学杂志

外文期刊名：Henan Journal of Surgery

语种：中文

中文关键词：特殊条件;胆总管结石伴梗阻;胆总管塑料支架

外文关键词：specific conditions;common duct stones combined obstruction;plastic biliary stent

摘要：目的评价特殊条件下放置塑料支架治疗胆总管结石伴梗阻的疗效、安全性、可行性。方法采用常规ERCP术,对20例病情特殊的胆总管结石患者(KPS评分低于50分)或伴高龄、基础疾病、严重感染等,在导丝引导下放置8.5F塑料胆道内支架治疗。结果20例患者手术全部成功,手术时间平均约15min,全部患者1周内上腹部疼痛缓解,感染控制,黄疸明显下降。随访时间4～9个月,其中2例感染控制后一般状况好转,行ERCP+气囊取石成功。8例术后6～9个月再次出现梗阻症状,行塑料支架更换术及内科保守治疗痊愈。10例患者随观4～6个月未见异常,所有患者未见ERCP或留置支架相关严重并发症。结论特殊条件下放置塑料支架治疗胆总管结石,操作简单、便捷、手术时间短、患者易耐受,近期及长期疗效较好、安全、可行。对一般状况差、伴高龄、基础疾病、严重感染等无法耐受外科手术和内镜下长时间操作,以及ERCP+常规取石困难的患者,是一种较好的治疗方法。
Objective To evaluate curative effects,security and feasibility of putting plastic biliary tent to cure common bile duct stones combined obstruction in specific conditions.Method Putting 8.5F plastic biliary tent inducted by guide wire to 20 special common duct stones combined obstruction patients(the score of KPS is below 50)or accompanying senior age,basic disease,serious infections and so on,by adoption of normal ERCP.Consequence The operations of 20 patients were all successful and the average operation time was about 15 minutes.Epigastrium pain of all patients was eased within one week,infections were under control and jaundice obviously declined.Follow up four to nine months,two of the patients’ general condition improved after infection control and used ERCP + pneumathode calculus removed successfully.Symptoms of obstructions appeared again in eight patients respectively within six to nine months after operation and cured by exchange of plastic tent and expectant treatment.Ten patients no abnormality were seen after followed upforfour to six months.Complications to ERCP or detaining stent didn’t appear in the all patients.Conclusion The operation of putting plastic tent to cure common duct stones under special situations is easy,convenient,time-saving,easy-endurable,good curative effects.It is safe and feasible too.It is a kind of good therapy to patients who are under poor general situations or can’t bear surgery operations and long time operate endoscope on account of senior age,basic ailments and serious infection,and the calculus removal are difficult with common methods.