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中华介入放射学电子杂志 ›› 2016, Vol. 04 ›› Issue (02) : 119 -123. doi: 10.3877/cma.j.issn.2095-5782.2016.02.014

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综述

恶性梗阻性黄疸的介入治疗进展
马少军1, 翟仁友1(), 赵峰1   
  1. 1. 300100 天津市南开医院介入血管科
  • 收稿日期:2016-04-10 出版日期:2016-05-01
  • 通信作者: 翟仁友

Advances in interventional therapy of malignant obstructive jaundice

Shaojun Ma1, Renyou Zhai1,(), Feng Zhao1   

  1. 1. Department of Interventional Vascular, The Naikai Hospital, 300100, China
  • Received:2016-04-10 Published:2016-05-01
  • Corresponding author: Renyou Zhai
  • About author:
    Corresponding author: Zhai Renyou, Email:
引用本文:

马少军, 翟仁友, 赵峰. 恶性梗阻性黄疸的介入治疗进展[J]. 中华介入放射学电子杂志, 2016, 04(02): 119-123.

Shaojun Ma, Renyou Zhai, Feng Zhao. Advances in interventional therapy of malignant obstructive jaundice[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2016, 04(02): 119-123.

恶性梗阻性黄疸(MOJ)是临床常见病症,梗阻以肿瘤压迫胆道狭窄为主要原因,早期缺乏典型症状,手术切除率低,预后极差。经皮肝穿刺胆管引流术(PTCD)及胆道支架置入术是MOJ最有效的解决方法,能有效缓解临床症状,改善肝功能,提高患者生活质量。介入联合化疗、125Ⅰ粒子植入、射频消融等方法治疗原发肿瘤,可显著延长患者生存期。术后积极抗感染治疗,可显著降低并发症。随着新一代抗肿瘤药物问世、介入器材和技术的不断进步、药膜内支架的开发与研究,为介入治疗提供了各种新的途径和手段,胆道内支架置入后有望保持长期畅通,大大延长患者生存期。

Malignant obstructive jaundice (MOJ) is a common clinical disease, in which a tumor presses the biliary stricture as the main reason to cause obstruction. Due to a lack of typical symptoms, MOJ usually has a low success rate of surgical resection and the prognosis is also poor. However, latest research from various prestigious labs nationally and internationally showed that percutaneous transhepatic biliary drainage (PTCD) and biliary stenting are the most effective methods for malignant obstructive jaundice. These methods can effectively relieve clinical symptoms, improve the liver function, and the quality of life of patients. PTCD combined with chemotherapy, 125Ⅰ seed implantation, radiofrequency ablation and other strategies targeting the primary tumors , can significantly prolong the patient’s survival, while active postoperative anti-infective therapy significantly reduced the complications. With the advent of new generations of anti-tumor drugs, interventional equipment and technology advances, the development of film stents and interventional therapy provides a variety of promising strategies and it is expected that patients with biliary stenting biliary patency, as will greatly extend the survival of patients.

1
徐川,施海彬,刘圣,等. 肝门部胆管癌致梗阻性黄疸介入引流治疗的预后分析[J]. 介入放射学杂志,2012,21(9):752-755. doi:10.3969/j.issn.1008-794X.2012.09.012.
2
Gulshan Parasher,Lee John G.. The role of ERCP in pancreato-biliary malignancies[M]. Advanced Digestive Endoscopy: ERCP, Blackwell Publishing Ltd, Oxford, UK. 2006, 6:120-141. doi: 10.1002/9780470987490.ch6
3
Dang YZ,Huang SG,Lu WL,et al. Curative effect of stereotactic body radiotheraty on hepatic carcinoma[J].Mol Clin Oncol,2014,2(6):1135-1138.
4
Ryan DP, Hong TS, Bardeesy N. Pancreatic adenocarcinoma[J]. N Engl J Med, 2014 ,371(11):1039-1049. doi: 10.1056/NEJMra1404198.
5
Moole H, Bechtold M, Puli SR.Efficacy of preoperative biliary drainage in malignant obstructive jaundice: a meta-analysis and systematic review[J]. World J Surg Oncol, 2016,14(1):182. doi: 10.1186/s12957-016-0933-2.
6
Jones C,Badger SA,Black JM,et al. The use of antiendotoxin peptides in obstructive jaundice endotoxemia[J]. Eur J Gastroenterol Hepatol,2012,24(3): 248-254. doi: 10.1097/MEG.0b013e32834dfb8c.
7
Zhang GY,Li WT,Peng WJ,et al. Clinical outcomes and prediction of survival following percutaneous biliary drainage for malignant obstructive jaundice[J]. Oncol Lett,2014,7(4):1185-1190.
8
Fang Y, Gurusamy KS, Wang Q, et al. Meta-analysis of randomized clinical trials on safety and efficacy of biliary drainage before surgery for obstructive jaundice[J]. Br J Surg, 2013, 100(12):1589–1596. doi: 10.1002/bjs.9260.
9
张小坚,张联合,张士良,等. 经内镜逆行胰胆管造影术与经皮肝穿刺胆道引流术治疗恶性梗阻性黄疸的比较[J]. 中华全科医学,2016,14(4):575-577. doi:10.16766/j.cnki.issn.1674-4152.2016.04.020.
10
Leng JJ, Zhang N, Dong JH. Percutaneous transhepatic and endoscopic biliary drainage for malignant biliary tract obstruction: a meta-analysis[J]. World J Surg Oncol,2014,12(1):272.
11
Miyazaki M, Shibuya K, Tokue H, et al. Percutaneous transhepatic biliary drainage assisted by real-time virtual sonography: a retrospective study[J].BMC Gastroenterology, 2013,13:127. doi: 10.1186/1471-230X-13-127.
12
Sharaiha RZ, Kumta NA, Desai AP,et al. Endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage: predictors of successful outcome in patients who fail endoscopic retrograde cholangiopancreatography[J]. Surg Endosc,2016 Apr 29. [Epub ahead of print]. doi: 10.1007/s00464-016-4913-y.
13
Tsauo J, Li X, Li H,et al. Transjugular insertion of bare-metal biliary stent for the treatment of distal malignant obstructive jaundice complicated by coagulopathy[J]. Cardiovasc Intervent Radiol, 2013,36(2):521-525. doi: 10.1007/s00270-012-0453-6.
14
南志宇,冯对平,谢春明,等. 经皮右侧入路行双侧胆道引流术治疗恶性高位梗阻性黄疸[J]. 中国介入影像与治疗学,2015,12(4):206-209.
15
Song TJ, Lee JH, Lee SS, et al.Metal versus plastic stents for drainage of malignant biliary obstruction before primary surgical resection[J]. Gastrointest Endosc, 2016, 84(5):814-821. doi: 10.1016/j.gie.2016.04.018.
16
路绪龙,白旭明,程龙等. 不同金属胆道支架对恶性梗阻性黄疸疗效比较[J]. 介入放射学杂志, 2014,23(7):606-610. doi:10.3969/j.issn.1008-794X.2014.07.013.
17
Hyun H, Choi SY, Kim KA,et al. Safety and efficacy of percutaneous biliary covered stent placement in patients with malignant biliary hilar obstruction;correlation with liver function[J]. Cardiovasc Intervent Radiol, 2016 ,39(9):1298-1305. doi: 10.1007/s00270-016-1375-5.
18
Tringali A, Mutignani M, Perri V, et al. A prospective, randomized multicenter trial comparing doublelayer and polyethylene stents for malignant distal common bile duct strictures[J]. Endoscopy, 2003,35(12):992–997.
19
Elwir S, Sharzehi K, Veith J,et al. Biliary stenting in patients with malignant biliary obstruction: comparison of double layer, plastic and metal stents[J]. Dig Dis Sci, 2013,58(7):2088-2092. doi: 10.1007/s10620-013-2607-z..
20
Roque J, Ho SH, Goh KL. Preoperative drainage for malignant biliary strictures: is it time for self-expanding metallic stents?[J]. Clin Endosc, 2015 ,48(1):8-14. doi: 10.5946/ce.2015.48.1.8.
21
Loew BJ,Howell DA,Sanders MK,et al. Comparative performance of uncoated,self-expanding metal biliary stents of different designs in 2 diameters: final results of an international multicenter,randomized,controlled trial[J]. Gastrointest Endosc, 2009,70(3):445-453. doi: 10.1016/j.gie.2008.11.018.
22
Kwon CI, Gromski MA, Sherman S,et al. Time sequence valuation of biliary stent occlusion by dissection analysis of retrieved stents[J]. Dig Dis Sci, 2016 , 61(8):2426-2435. doi: 10.1007/s10620-016-4135-0.
23
牛洪涛,翟仁友,王剑锋,等. 恶性梗阻性黄疸介入治疗联合灌注化疗疗效评估[J/CD]. 中华介入放射学电子杂志,2014,2(3):20-23. doi:10.3877/cma.j.issn.2095-5782.2014.03.006.
24
Shah T. Drug-eluting stents in malignant biliary obstruction: where do we stand?[J/CD].Dig Dis Sci, 2013 ,58(3):610-612. doi: 10.1007/s10620-012-2507-7.
25
黄兢姚,杨维竹,江娜,等.经胆道支架置入放射性粒子条治疗恶性胆道梗阻[J].中华介入放射学电子杂志,2014,2(2):46-49. doi:10.3877/cma.j.issn.2095-5782.2014.02.013.
26
阿斯哈尔.哈斯木,顾俊鹏,张海潇,等. 125I粒子条联合胆道支架治疗恶性梗阻性黄疸初步疗效评价[J].中国介入影像与治疗学,2015,12(5):284-288.
27
苟庆,王一焯,周泽健,等. 胆道支架联合125I粒子植入术治疗肝门区肿瘤合并梗阻性黄疸[J]. 临床放射学杂志,2016,35(4):621-625.
28
Wang T, Liu S, Zheng YB, et al. Application of (125)I seeds combined with biliary stent implantation in the treatment of malignant obstructive jaundice[J]. Zhonghua Zhong Liu Za Zhi, 2016 ,38(3):228-231. doi: 10.3760/cma.j.issn.0253-3766.2016.03.013.
29
赵秋盛,黄少辉.射频消融导管联合支架介入治疗恶性梗阻性黄疸的临床研究[J/CD]. 中华介入放射学电子杂志,2016,4(1):32-35. 10.3877/cma.j.issn.2095-5782.2016.01.009.
30
Wang J, Zhao L, Zhou C, et al. Percutaneous intraductal radiofrequency ablation combined with biliary stent placement for nonresectable malignant biliary obstruction improves stent patency but not survival[J]. Medicine (Baltimore), 2016 ,95(15):e3329. doi: 10.1097/MD.0000000000003329.
31
Duan XH, Wang YL, Han XW, et al. Intraductal radiofrequency ablation followed by locoregional tumor treatments for treating occluded biliary stents in non-resectable malignant biliary obstruction: a single-institution experience[J].PLoS One,2015,10(8):e0134857. doi: 10.1371/journal.pone.0134857.
32
Baran TM, Mironov O, Sharma AK,et al.Indwelling stent embedded with light-emitting diodes for photodynamic therapy of malignant biliary obstruction[J]. Cardiovasc Intervent Radiol,2016 ,39(6):916-919. doi: 10.1007/s00270-015-1241-x.
33
张凯,张萌帆,任建庄,等. 胆道支架联合抗肿瘤治疗对肝外胆管癌治疗疗效分析[J/CD]. 中华介入放射学电子杂志,2015,3(1):23-26. doi:10.3877/cma.j.issn.2095-5782.2015.01.006.
34
于海鹏,郭志. 恶性梗阻性黄疸合并感染病原学研究现状[J/CD].中华介入放射学电子杂志,2013,1(2):140-141. doi:10.3877/j.issn.2095-5782.2013.02.016.
35
Yu H, Guo Z, Xing W.et al. Bile culture and susceptibility testing of malignant biliary obstruction via PTBD[J]. Cardiovasc Intervent Radiol,2012,35(5):1136-1144.
36
Haag GM, Herrmann T, Jaeger D,et al.Outcomes and risk factors for cancer patients undergoing endoscopic intervention of malignant biliary obstruction[J].BMC Gastroenterol, 2015, 15:171. doi: 10.1186/s12876-015-0399-7.
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