经皮穿刺胰管引流及支架置入术在胰腺癌姑息治疗中的应用

目的 介绍经皮穿刺胰管引流、胰管支架置入治疗胰腺癌胰管梗阻的介入手术方法及疗效.方法 4例影像学及手术病理证实的晚期胰腺癌伴胰管梗阻患者,在CT和DSA联合导向下,行经皮胰腺穿刺胰管外引流和支架置入术.结果 4例患者胰管引流及支架置入术均获成功,未出现急性胰腺炎等并发症.术后2例脂肪泻症状完全消失,2例明显减轻;4例上腹部疼痛均明显缓解.随访3～10个月,症状持续缓解时间3～7个月,平均4.8个月.结论 经皮胰腺穿刺胰管外引流及支架置入术操作安全,能有效缓解胰腺癌胰管梗阻引起的脂肪泻和疼痛症状,提高患者生活质量.

Application of percutaneous pancreatic duct draining and stenting in palliative treatment of pancreatic carcinoma

Objective To introduce the methods and effects of percutaneous pancreatic duct draining and stenting in patients with obstructive pancreatic duct of pancreatic carcinoma. Methods Four patients with pancreas carcinoma accompanied by pancreatic duct obstruction were undertaken percutaneous puncture of pancreatic duct and followed by drainage tube insertion and metallic stents placement under CT and DSA guidance. Results Percutaneous pancreatic duct draining and stenting were successful in all 4 patients without acute pancreatitis and other complications. After the procedure, fat diarrhea disappeared in 2 cases and alleviated in other 2. The upper abdominal pain also alleviated in all 4 patients. Follow-up of 3 to 10 months, the clinical symptoms were persistantly released for 3 to 7 months, with a median 4.8 months. Conclusion Percutaneous pancreatic duct draining and stenting is safe and efficiency for relief of fat diarrhea and painful symptoms caused the pancreatic duct obstruction in pancreatic cancinoma and thus improve the quality of life.