关键词: 经内镜胆道金属支架置入术, 胆道感染, 肝脓肿, 急性化脓性胆囊炎, 经皮经肝胆囊穿刺置管引流术, 经皮经肝脓肿穿刺置管引流

Abstract:

Objective  To investigate the reasons and treatment of infection of biliary tract after endoscopic biliary metalstent drainage. Methods  The clinical data of 47 cases who undergone the treatment of endoscopic biliary metal stent drainage (EBMSD) from Jan. 2011 to Dec. 2012 was analyzed retrospectively. Results  All 47 cases were successfully implanted biliary metal stent. Six cases of hilar cholangiocarcinoma, 3 cases of bile duct carcinoma (common bile duct), 2 cases of ampullary carcinoma and 1 case of anastomotic stricture after liver transplantation occurred infection of biliary tract in 3 weeks to 31 months after EBMSD, which including  4 cases of tumor ingrowth bracket, 3 cases of biliary sludge and chyme siltation, 3 cases of acute suppurative cholecystitis and 2 cases of liver abscess. All 12 cases were cured by percutaneous transhepatic gallbladder drainage (PTGBD), percutaneous transhepatic cholangial drainage (PTCD), endoscopic balloon stone extraction/covered metal stents and nasal biliary drainage. Conclusion  Biliary sludge and chyme siltation, liver abscess, tumor ingrowth stent and the squeeze of gallbladder neck opening are the main reason of infection of biliary tract after EBMSD. PTGBD, PTCD and therapeutic ERCP are the main treatment.

Key words: endoscopic biliary metal stent drainage')">

endoscopic biliary metal stent drainage, infection of biliary tract, liver abscess, acute suppurative cholecystitis, percutaneous transhepatic gallbladder drainage, percutaneous transhepatic cholangial drainage