关键词: 经内镜逆行胰胆管造影, 高位胆管恶性梗阻, 姑息治疗, 双支架

Abstract: ［Abstract］ Objective The aim of this study is to discuss the efficacy of biliary stent implantation under endoscopy in malignant biliary hilar obstruction and its influencing factors. Methods We evaluated the success rate， effective drainage rate， the incidence of complications， 30 d mortality rate， duration of unobstructed stent and survival time for 168 cases who underwent biliary stent implantation under endoscopy from Aug. 2008 to Apr. 2014， who were retrospectively analyzed. Results In 168 cases， 148 were successfully implanted with plastic or metal stents through endoscopic retrograde cholangiopancreatography （ERCP）， among them， 13 were performed under a reunion operation which combines percutaneous transhepatic cholangio （PTC） and ERCP， and the success rate was 88.1%|another 20 cases failed in both and were converted to PTCD external drainage|the effective drainage rate was 91.9%， the incidence of early complications was 23.0%， the total effective time of stents was 59 days， and median survival time was 248 days. Conclusion These pilot results indicate that different treatment protocols should be chosen according to individualized principle|and clinical doctors should pay attention to effective operation and the reduction of complications.

Key words: endoscopic retrograde cholangiopancreatography, malignant biliary hilar obstruction, double stents, alleviative treatment