經皮穿肝膽道內管留置術

PERCUTANEOUS TRANSHEPATIC BILIARY ENDOPROSTHSIS

石井宏(Hiroshi Ishii) ； 蔣咸嘉(Hsein-Jar Chaiang) ； 黃倫奕(Lun-Yick Wong)

《中華放射線醫學雜誌》 12卷3期 (1987/09) Pp. 277-282

摘要

由於罹患惡性疾病而導致阻塞性黃疸，雖可經由內視鏡逆行性膽汁外引流術、經皮穿肝膽汁引流術、或外科手術將膽汁引流，而達到治療的目的。但因阻塞位置及解剖相關位置的關係，其開刀死亡率及手術後的生存期，都不盡理想，且手術前後的死亡率，更高達59%，手術後更會有粘黏、局部腫瘤、瘻管、肺炎、消化道出血及肺部栓塞等併發症發生。若程由經皮穿肝膽道內管留置術，則不但可以避免開刀之苦，且可達到治療阻塞性黃疸的效果。在經皮穿肝膽道向管留置術的施行過程中，不僅引發較大合併的可能性很低，而且較能降低血清膽色素值。其平均下降率為3.04 mg%/day（範圍話8.00 mg%/day-0.58mg%/day）。

並列摘要

In patients with malignant diseases causing obstructive jaundice, several procedures are available in relieving the obstruction, such as endoscopic retrograde biliary drairiage, percutaneous transhepatic biliary drainage and/or surgical drainage procedures. Because of the nature of the obstructing lesion and its anatomical relationship, drainage procedure using surgical means is associated with high incidence of operative mortality and low postoperative survival rate. The perioperative mortality can be as high as 59%. Associated postoperative complications are adhesions, localized abscess, flstula formation, pneumonia, gastrointestinal tract hemorrhage and pulmonary embolism. Using percutaneous transhepatic biliary stenting procedure, not only the hazards of surgery can be avoided but also can attain satisfactory relief of the obstructive jaundice. This procedure has a very low incidence of major complication and can lower the serum bilirubin level to 8.00 mg%/day - 0.58 mg%/day, with an average of 3.04 mg%/day.