Résumé
Objective To investigate the clinical value and therapeutic effect of biliary stent insertion(EMBE, ERBD)and ENBD via endoscopic retrograde cholangio-pancreatography(ERCP)on malignant obstructive jaundice.Methods A retrospective review was conducted of 51 patients with malignant obstructive jaundice receiving ERCP in our hospital from June 2002 to March 2009.Different biliary stents or ENBD were placed into their biliary duct to drain bile.Meanwhile, the efective power, incidence rate, unobstructive time, and live time were determined.Results ERCP was successfully performed in all these 51 cases and 31 of them were successfully embedded with self-expandable metal stents while 15 of them had plastic stents.The last 2 cases were only treated with ENBD.Eleven cases had complications, but none of them had sequela after prompt treatment.In 48 cases, the serum level of total bilirubin decreased from(279.6±143.7)μmol/L to(125.7±78.3)μmol/L after drainage(P＜0.01).The follow-up investigation in 39 cases indicated that the 3-and 6-month survival rates after the treatment were 91% and 74%, respectively.Conclusion Biliary stent insertion and ENBD via duodenoscopy is an effective and safe palliative treatment for malignant bile duct obstruction.
Résumé
Objective To discuss the value of intraoperative transnasal cholangiography in endoscopic sphincterotomy(EST) combined with laparoscopic cholecystectomy(LC) for treating cholelithiasis complicated with choledocholithiasis.Methods The EST was carried out to treat common bile duct stones and to conduct the endoscopic nasobiliary drainage(ENBD).During the LC the cholangiography was performed by way of ENBD.Results Intraoperative cholangiography was successfully completed in all 46 cases,with a cholangiography time of 5~15 min(mean,8.2 min).Secondary common duct stones migrated from the gallbladder were found by cholangiography in 4 cases,in 2 of which the stones were removed under endoscope during the procedure,and in 2 of which the stones were