背景:恶性胆道梗阻的姑息治疗很重要,通常通过经皮胆道支架置入术进行。我们这项研究的主要目的是评估壁支架的性能,和镍钛诺支架用于缓解恶性胆道梗阻。
方法:回顾性分析1995年1月1日至2005年12月31日在我科接受胆道支架置入术的157例患者的病历。技术上的成功,治疗成功,头30天的死亡率,未成年人,和主要并发症在壁支架之间进行评估和比较,所有患者的镍钛诺支架组构成主要研究终点。此外,支架通畅,在可获得随访信息的患者中评估支架植入术后的平均患者生存时间.
结果:共在157例患者中放置了213个金属支架。在平均年龄的83例患者中放置了壁支架,SD为60.4和13.5。在74例患者中放置了镍钛诺支架,平均年龄为57.8岁,SD为15.5。两组的性别比例相等。在镍钛诺治疗的13例患者中观察到胆道支架功能障碍,和壁支架组在整个研究期间。再闭塞率之间没有统计学差异(p=0.91)。对于镍钛诺支架组,中位主要通畅时间为119天(90-185天CI95%),壁支架组的中位主要通畅时间为81天(60-150天CI95%).
结论:镍钛诺支架,和壁支架是安全的选择,可以安全地用于恶性胆道梗阻的经皮治疗,具有相似的治疗和治疗成功,并发症发生率低,和通畅时间可能超出预期的生存时间。
BACKGROUND: Palliation of malign biliary obstruction is important which is commonly carried out by percutaneous biliary stenting. Our primary aim with this study was assessment of performance of wall stents, and nitinol stents for the
palliation of malign biliary obstruction.
METHODS: The medical records of 157 patients who underwent biliary stenting in our department between January 1, 1995, and December 31, 2005, were retrospectively analyzed. Technical success, treatment success, mortality in the first 30 days, minor, and major complications were evaluated and compared among the wall stent, and the nitinol stent groups in all patients which constituted the primary study endpoints. Additionally, stent patency, and mean patient survival times after stent implantation were evaluated in patients for whom follow-up information could be obtained.
RESULTS: A total of 213 metallic stents were placed in 157 patients. Wall stent was placed in 83 of the patients with mean age, and SD of 60.4 and 13.5. Nitinol stent was placed in 74 of the patients with mean age of 57.8, and SD of 15.5. Gender ratio was equal in both groups. Biliary stent dysfunction was observed in 13 patients in each of nitinol, and wall stent groups throughout the study period. There was no statistical difference among re-occlusion rates (p = 0.91). For the nitinol stent group median primary patency time was 119 days (90-185 days CI 95%), and for the wall stent group median primary patency time was 81 days (60-150 days CI 95%).
CONCLUSIONS: Nitinol stents, and wall stents are safe options that can be safely used in the percutaneous treatment of malignant biliary obstruction with similar treatment and therapeutic success, low complication rates, and patency times that can extend beyond expected survival times.