目的探讨晚期恶性梗阻性黄疸减黄、保肝的处理方式。方法回顾性分析我科2008年1月至2009年10月期间收治的80例恶性梗阻性黄疸患者，根据肿瘤部位、患者身体、经济条件等确定无法行根治性手术者，采用不同的减黄术式。结果本组80例患者中，9例行PTCD，42例行PTBS，29例行ERBD。并发症发生情况: PTBS组有15例，ERBD组6例，PTCD组2例。PTCD组的住院时间和住院费用明显低于PTBS组和ERBD组(Plt;0.05)。结论晚期恶性梗阻性黄疸，一经确诊，尽早处理，微创引流减黄是首选方式。
目的探讨经皮经肝胆管穿刺引流（PTCD）、经皮腹腔穿刺引流及Roux-en-Y胆管空肠吻合术序贯治疗高位胆管损伤合并胆漏的疗效。方法对我中心2004年5月至2009年5月期间收治的5例高位胆管损伤合并胆漏的患者，应用PTCD、经皮腹腔穿刺引流、Roux-en-Y胆管空肠吻合术序贯治疗过程及疗效进行回顾性分析。结果5例患者均获痊愈，随访3~24个月，未发生胆管再次狭窄、胆管炎等并发症。结论PTCD、经皮腹腔穿刺引流后，再进行Roux-en-Y胆管空肠吻合术是治疗高位胆管损伤合并胆漏的首选方法。
ObjectiveTo 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. MethodThe 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. ResultsFifty-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. ConclusionPTCD 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.