悪性胆道狭窄に対するmetallic stentの留置の問題点と対策

DOI 被引用文献2件 参考文献7件

書誌事項

タイトル別名
  • Problems and treatments for improving the QOL in the endoprosthesis by metallic stents for malignant biliary stenosis
  • QOLの向上をめざして

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抄録

Metallic stents (MS) were widely used as a noninvasive biliary endoprosthesis. However, we sometimes experience a case without improving the quality of life (QOL), that is an essential aim, following the placement of metallic stents. In this study, the problems and its treatments for improving the QOL were evaluated from our experiences. The occurrences of restenosis and complication in 51 cases with malignant biliary stenosis were evaluated on each background such as the route of insertion, sorts of devices, causative disease, stenosis levels and adjuvant therapy. The restenosis occurred in 29% and 80% of the reasons were the tumor growth. The severe complications were present in 14%. Although the average rate of successful placement through each route alone such as transhepatic or transpapillary was 86%, the successful rate increased to 94%by using the other route if one route was failed. The significant differences of the number of restenosis were seen in the sort of device (Wallstent<the others) and causative disease (pancreatic cancer<bile duct cancer, lymphnode metastasis). On the other hand, the complications did not have a significant difference on every background.75% of the cases complicated with refractory cholangitis or liver abscess were without preserving the function of papilla. Therefore, the important points for improving the QOL on MS placement were as follows.1) The other route should be tried for the refractory to the insertions.2) The use of Wallstent is recommended.3) The longer MS should be indicated for the lymphnode metastasis that is easy to grow longitudinally.4)The function of papillia is to be preserved as much as possible.

収録刊行物

  • Tando

    Tando 12 (4), 321-325, 1998

    Japan Biliary Association

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