Cause and Management of Complications of PTCD Combined with Percutaneous Transhepatic Implantation of Biliary Stent in Treating for Advanced Malignant Biliary Obstruction_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 WANGHua ,  WANGTao , TANGLi-jun

Center of General Surgery, Chengdu Military General Hospital, Chengdu 610083, Sichuan Province, China;

Corresponding author：

WANGTao, Email: watopo@163.com

Keywords：

Advanced malignant biliary obstruction; Percutaneous transhepatic cholangial drainage; Percutaneous transhepatic implantation of biliary stent; Complications; Treatment

DOI：

10.7507/1007-9424.20140338

Video：

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Objective To analyze the cause of complications for patients with advanced malignant biliary obstruc-tion treated with percutaneous transhepatic implantation of biliary stent (PTBS) and summarize the experiences of comp-lications of the treatment. Method The complications of 59 patients firstly treated with percutaneous transhepatic cholangial drainage (PTCD) then with PTBS in 156 cases of advanced malignant biliary obstruction from January 2010 to January 2013 in this hospital were analyzed retrospectively. Results Fifty-nine cases of complications were occurred in 156 cases of advanced malignant biliary obstruction, the incidence was 37.8%, including biliary infection in 26 cases, bile duct bleeding in 17 cases, liver failure in 5 cases, renal failure in 4 cases, acute pancreatitis in 4 cases, stent displa-cement in 2 cases, bile duct perforation in 1 case.Three cases died in 59 patients with complications, 56 cases were improved after symptomatic treatment. Conclusion PTCD combined with PTBS is a safe and effective treatment of advanced malignant biliary obstruction, the reasonable perioperative management is very important to reduce the occurrence of complications.

Citation： WANGHua, WANGTao, TANGLi-jun. Cause and Management of Complications of PTCD Combined with Percutaneous Transhepatic Implantation of Biliary Stent in Treating for Advanced Malignant Biliary Obstruction. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(11): 1421-1424. doi: 10.7507/1007-9424.20140338 Copy

1.	黄志强.胆道外科手术学[M].济南:山东科学技术出版社, 1998:168-170.
2.	郝玉芝, 邢冬娟, 龚少娟, 等.PTCD并胆道支架治疗恶性梗阻性黄疸临床观察[J].肝胆外科杂志, 2013, 21(6):447-450.
3.	范恒伟, 刘会春, 李宗狂, 等.经PTCD途径胆道金属支架置入术治疗恶性梗阻性黄疸137例临床疗效分析[J].肝胆外科杂志, 2013, 21(2):94-97.
4.	王华, 汪涛.经PTCD窦道胆道金属支架置入术治疗恶性梗阻性黄疸临床疗效分析[J].第三军医大学学报, 2011, 33(13):1337, 1345.
5.	杨琦, 陈之强, 彭正.经皮肝穿胆道支架植入术治疗恶性梗阻性黄疸的研究[J].中华全科医学, 2013, 11(1):82-83.
6.	徐永辉, 凌永志, 邱艺琼.经皮经肝胆道内支架置入术在恶性梗阻性黄疸中的应用[J].现代诊断与治疗, 2011, 22(6):337-338.
7.	石力, 汤礼军, 汪涛, 等.胆道金属支架置入治疗肝门部胆管癌的临床研究[J].中国普通外科杂志, 2012, 21(8):918-921.
8.	毛伟征, 杨金镛, 崔自介.梗阻性黄疸患者术前胆道感染与术后多器官功能障碍综合征的临床研究[J].腹部外科, 1999, 12(2):28-29.
9.	王刚, 钟红姗, 王洪新, 等.PTCD联合胆道支架置入术治疗恶性梗阻性黄疸39例临床疗效分析[J].中国普外基础与临床杂志, 2013, 20(12):1417-1420.
10.	黄万里, 梁宏伟, 王书长, 等.介入治疗恶性梗阻性黄疸的临床疗效研究[J].医学综述, 2011, 17(3):471-473.
11.	翟仁友, 戴定可, 于平, 等.重视PTBD并发症的预防和处理[J].当代医学:中国介入放射学, 2008, 2(2):104-105.
12.	汤靓, 周伟平.梗阻性黄疸病理生理学改变[J].中国实用外科杂志, 2007, 27(10):839-841.
13.	胡铭荣, 徐德征.654-2对梗阻性黄疸内毒素致肾脏损害的临床干预[J].中国现代普通外科进展, 2001, 4(1):42-44.
14.	George C, Byass OR, Cast JE.Interventional radiology in the management of malignant biliary obstruction[J].World J Gastrointest Oncol, 2010, 2(3):146-150.
15.	孙铎, 刘永刚, 杨俊清, 等.PTCD与ERCP联合术治疗恶性阻塞性黄疸疗效分析[J].中华肝胆外科杂志, 2010, 16(4):308-309.
16.	曹广劭, 曹会存, 刘健, 等.阻塞性黄疸介入治疗的并发症分析[J].当代医学, 2010, 16(11):186-188.
17.	夏永辉, 徐克, 苏洪英, 等.晚期恶性梗阻性黄疸经皮介入治疗近期并发症的临床观察及处理[J].当代医学, 2009, 3(5):88-90.
18.	李伟, 周政, 朱晓黎, 等.恶性梗阻性黄疸介入治疗并发症的分析及处理[J].当代医学, 2011, 17(5):81-83.
19.	梁松年, 苏洪英, 冯博, 等.恶性梗阻性黄疸介入治疗后近期并发症的分析和处理[J].介入放射学杂志, 2012, 21(11):927-930.

1. 黄志强.胆道外科手术学[M].济南:山东科学技术出版社, 1998:168-170.
2. 郝玉芝, 邢冬娟, 龚少娟, 等.PTCD并胆道支架治疗恶性梗阻性黄疸临床观察[J].肝胆外科杂志, 2013, 21(6):447-450.
3. 范恒伟, 刘会春, 李宗狂, 等.经PTCD途径胆道金属支架置入术治疗恶性梗阻性黄疸137例临床疗效分析[J].肝胆外科杂志, 2013, 21(2):94-97.
4. 王华, 汪涛.经PTCD窦道胆道金属支架置入术治疗恶性梗阻性黄疸临床疗效分析[J].第三军医大学学报, 2011, 33(13):1337, 1345.
5. 杨琦, 陈之强, 彭正.经皮肝穿胆道支架植入术治疗恶性梗阻性黄疸的研究[J].中华全科医学, 2013, 11(1):82-83.
6. 徐永辉, 凌永志, 邱艺琼.经皮经肝胆道内支架置入术在恶性梗阻性黄疸中的应用[J].现代诊断与治疗, 2011, 22(6):337-338.
7. 石力, 汤礼军, 汪涛, 等.胆道金属支架置入治疗肝门部胆管癌的临床研究[J].中国普通外科杂志, 2012, 21(8):918-921.
8. 毛伟征, 杨金镛, 崔自介.梗阻性黄疸患者术前胆道感染与术后多器官功能障碍综合征的临床研究[J].腹部外科, 1999, 12(2):28-29.
9. 王刚, 钟红姗, 王洪新, 等.PTCD联合胆道支架置入术治疗恶性梗阻性黄疸39例临床疗效分析[J].中国普外基础与临床杂志, 2013, 20(12):1417-1420.
10. 黄万里, 梁宏伟, 王书长, 等.介入治疗恶性梗阻性黄疸的临床疗效研究[J].医学综述, 2011, 17(3):471-473.
11. 翟仁友, 戴定可, 于平, 等.重视PTBD并发症的预防和处理[J].当代医学:中国介入放射学, 2008, 2(2):104-105.
12. 汤靓, 周伟平.梗阻性黄疸病理生理学改变[J].中国实用外科杂志, 2007, 27(10):839-841.
13. 胡铭荣, 徐德征.654-2对梗阻性黄疸内毒素致肾脏损害的临床干预[J].中国现代普通外科进展, 2001, 4(1):42-44.
14. George C, Byass OR, Cast JE.Interventional radiology in the management of malignant biliary obstruction[J].World J Gastrointest Oncol, 2010, 2(3):146-150.
15. 孙铎, 刘永刚, 杨俊清, 等.PTCD与ERCP联合术治疗恶性阻塞性黄疸疗效分析[J].中华肝胆外科杂志, 2010, 16(4):308-309.
16. 曹广劭, 曹会存, 刘健, 等.阻塞性黄疸介入治疗的并发症分析[J].当代医学, 2010, 16(11):186-188.
17. 夏永辉, 徐克, 苏洪英, 等.晚期恶性梗阻性黄疸经皮介入治疗近期并发症的临床观察及处理[J].当代医学, 2009, 3(5):88-90.
18. 李伟, 周政, 朱晓黎, 等.恶性梗阻性黄疸介入治疗并发症的分析及处理[J].当代医学, 2011, 17(5):81-83.
19. 梁松年, 苏洪英, 冯博, 等.恶性梗阻性黄疸介入治疗后近期并发症的分析和处理[J].介入放射学杂志, 2012, 21(11):927-930.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Cause and Management of Complications of PTCD Combined with Percutaneous Transhepatic Implantation of Biliary Stent in Treating for Advanced Malignant Biliary Obstruction

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