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经皮胆道引流的结果

时间:2018-04-19 06:27来源:未知 作者:Mr.Editor 点击:
Prospective Study of outcomes after percutaneous biliary drainage for malignant biliary obstruction Robson et al Ann Surg Oncol 2010; 17 :2303-11 Pruritus improved by PBD No improvement in QoL scores High technical success rate Effective r

• Prospective Study of outcomes after percutaneous biliary drainage for malignant biliary obstruction【1】
                                                                                                
• Pruritus improved by PBD
• No improvement in QoL scores


• High technical success rate
• Effective relief of some symptoms particularly pruritus
• 30 day mortality significant
   – Consider appropriate patient selection
   – Consider potential surgery or chemotherapy



BSIR Biliary Register【2】:

• 833 patients, 62 Radiologists, 44 Hospitals
• Aetiology of obstruction –malignant in 88%
    – 42.2% pancreatic adenocarcinoma
• 98.7% technical success rate
• Bilirubin reduction 88.5%
• Partial / complete symptom relief 65%
    –  bilirubin下降 < 50% -29% complete relief
    -   bilirubin下降  > 50% -57% complete relief

• In hospital mortality 19.8%
• 1 Year survival < 20%
• Mortality rates
  –5 xhigher than open AAA repair
   –10 xcardiac surgery

Expected Survival【2】

• Pancreatic adenocarcinoma
   – Locally advanced 6 –10 months
   – Metastatic3 –6 months
• Cholangiocarcinoma< 12 months
• Gall bladder cancer6 months
• Intra-hepatic metastases


Success Rates

•Reported series > 50 patients
•Technical success rates > 95%
•Clinical success rates 60 –80%

 
1. Robson et al Ann Surg Oncol 2010; 17 :2303-11
2. Uberoiet al CVIR online Feb 2011(编辑:Mr.Editor)
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