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首页> 外文期刊>The Chinese-German Journal of Clinical Oncology >Endoscopic Palliative Treatment for Malignant Obstructive Jaundice: A Report of 929 Cases
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Endoscopic Palliative Treatment for Malignant Obstructive Jaundice: A Report of 929 Cases

机译：内镜姑息治疗恶性梗阻性黄疸929例报告

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Objective To review the experience with endoscopic palliative treatment for malignant obstructive jaundice (MOJ) in 929 patients. Methods 929 patients (598 males and 331 females) underwent 1 215 endoscopic palliative drainages for MOJ in our hospital. Tumor obstruction occurred in the distal common bile duct (CBD) (263 patients) , the middle CBD (43) , and the hilum (909). The mean biliru-bin level was 284.3μmol/L(range 26- 810) . Of the 1 215 drainages, 599 were performed by stenting with plastic endoprosthesis, 385 by naso-biliary catheterization, 167 by expandable metal stents, 39 by combined drainage method, 19 by tumor sphincterotomy and 6 by endoscopic fistulostomy. Results The successful rate of endoscopic procedure was 94.3%. The jaundice symptom was improved in 81.8% of the patients with a significant reduction of serum bilirubin in 64.7% . The complication after treatment occurred in 23 cases (2.6%) , including cholangitis (23 cases) , pancreatitis (8 cases), and bleeding (one case) , and 3 cases were dead (0.2%) . The median survival time of all patients was 14 months and life time analysis showed a life expectancy of 75.9%, 44.0% and 25.2% at 1, 2 and 3 years respectively. Conclusion In the patients with MOJ secondary to pancreatobiliary malignancy, successful endoscopic drainage provides adequate relief of biliary obstruction and is associated with low morbidity and mortality. Endoscopic interventional treatment may be considered as an alternative of palliative biliary operation for the late stage of pancreatic and biliary malignancies.
机译：目的探讨929例恶性梗阻性黄疸患者的内镜姑息治疗经验。方法929例患者（男598例，女331例）在我院行内镜下姑息引流术1 215例。肿瘤阻塞发生在远端胆总管（CBD）（263例），中部CBD（43）和肺门（909）。平均胆红素水平为284.3μmol/ L（范围26-810）。在1 215例引流中，有599例通过塑料假体支架置入，385例经鼻胆管插管，167例通过可扩张金属支架置入，39例经联合引流法，19例经肿瘤括约肌切开术，6例经内镜瘘管切开术。结果内镜手术成功率为94.3％。黄疸症状改善81.8％的患者，血清胆红素显着降低64.7％。治疗后并发症发生23例（2.6％），其中包括胆管炎（23例），胰腺炎（8例）和出血（1例），有3例死亡（0.2％）。所有患者的中位生存时间为14个月，寿命分析显示在1年，2年和3年时的预期寿命分别为75.9％，44.0％和25.2％。结论继发于胰腺胆道恶性肿瘤的MOJ患者，成功的内镜下引流术可充分缓解胆道梗阻，并具有较低的发病率和死亡率。对于胰腺和胆道恶性肿瘤的晚期，内镜介入治疗可被视为姑息性胆道手术的替代方法。

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