经皮经肝单侧入路双支架植入术治疗肝门部胆管梗阻

目的评价经皮经肝穿刺单侧入路双支架植入术治疗左、右肝管同时受累的肝门部胆管梗阻的疗效和临床价值。方法8例左、右肝内胆管同时受累的肝门部胆管梗阻病人,经皮经右肝或左肝单侧入路,通过在左、右肝管间和肝管、胆总管间植入金属双支架行胆管内引流,并结合抗肿瘤治疗。结果8例16枚支架全部放置成功,术后2周总胆红素由术前的（267.1±154.7）μmol/L下降至（61.2±13.4）μmol/L,无严重并发症及死亡病例。结论左、右肝管同时受累的肝门部胆管梗阻患者行单侧入路双支架植入技术并结合抗肿瘤治疗是一种安全,有效,可靠的治疗肝门部胆管的方法。

Double Stents Placed in Treatment of Patients with Hilar Obstructions by One-sided Percutaneous Transhepatic Biliary Puncture

Objective To evaluate the effect and value of double stents in treatment of hilar obstructions via one-sided percutaneous transhepatic biliary puncture. Methods Intra-drainage for bilateral liver lobes were performed through double stents that placed percutaneously between right-left intrahepatic duct and hepatic-common duct via one-sided puncture in 8 patients with hilar obstructions,all the cases also combined with anti-tumor therapy. Results Sixteen stents were placed in 8 patients successfully. The level of Total Bilirubin was decreased from （267.1±154.7）μmol/L to （61.2±13.4） μmol/L two weeks after operation,and no severe complications and decease was found. Conclusion Intra-drainage of bilateral hepatic ducts via one-sided puncture combined with anti-tumor therapy is a safe,effect,reliable technique in the treatment of hilar obstructions with both sides of heptic duct involved.