Zhonghua yi xue za zhi · 2015
[Prevention and treatment of complications for full-covered self-expanding removable metal stents in malignant obstructive jaundice].
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Zhang Cheng, Yang Yulong, Wu Ping, Ma Yuefeng, Zhang Hongwei, Lin Meiju, Shi Lijun, Li Jingyi, Zhao Mu
Аннотация
OBJECTIVE: To explore the prevention and treatment of complications for full-covered self-expanding removable metal stents (FCSERMS) in malignant obstructive jaundice.
METHODS: The clinical data were analyzed retrospectively for 45 cases undergoing endoscopic biliary FCSERMS drainage for malignant obstructive jaundice from May 2012 to March 2014.
RESULTS: Among them, 45 cases were successful one time. The parameters of liver function improved significantly with a jaundice efficiency of 91.1%. There were 4 dead cases. Among 19 cases of early complications, hyperamylasemia (n = 8), acute mild pancreatitis (n = 4), acute cholecystitis (n = 2) and hemobilia (n = 1) recovered after conservative treatments. Acute suppurative cholecystitis (n = 2) and acute obstructive suppurative cholangitis (n = 2) were cured by percutaneous transhepatic cholangial drainage (PTCD) and percutaneous transhepatic gallbladder drainage (PTGBD). And late complications of obstructive jaundice (n = 3), acute suppurative cholecystitis (n = 4), acute cholangitis (n = 2), hepatophyma (n = 2) and acute pancreatitis (n = 1) were cured by endoscopic retrograde cholangiopancreatography (ERCP), PTCD and PTGBD.
CONCLUSION: Various complications are associated with FCSERMS in malignant obstructive jaundice.However, positive and effective prevention and proper treatment reduce the incidence of complications.
METHODS: The clinical data were analyzed retrospectively for 45 cases undergoing endoscopic biliary FCSERMS drainage for malignant obstructive jaundice from May 2012 to March 2014.
RESULTS: Among them, 45 cases were successful one time. The parameters of liver function improved significantly with a jaundice efficiency of 91.1%. There were 4 dead cases. Among 19 cases of early complications, hyperamylasemia (n = 8), acute mild pancreatitis (n = 4), acute cholecystitis (n = 2) and hemobilia (n = 1) recovered after conservative treatments. Acute suppurative cholecystitis (n = 2) and acute obstructive suppurative cholangitis (n = 2) were cured by percutaneous transhepatic cholangial drainage (PTCD) and percutaneous transhepatic gallbladder drainage (PTGBD). And late complications of obstructive jaundice (n = 3), acute suppurative cholecystitis (n = 4), acute cholangitis (n = 2), hepatophyma (n = 2) and acute pancreatitis (n = 1) were cured by endoscopic retrograde cholangiopancreatography (ERCP), PTCD and PTGBD.
CONCLUSION: Various complications are associated with FCSERMS in malignant obstructive jaundice.However, positive and effective prevention and proper treatment reduce the incidence of complications.