Covey Anne M, Brown Karen T
Department of Diagnostic Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA.
J Support Oncol. 2006 Jun;4(6):269-73.
A diagnosis of liver metastasis, periportal adenopathy, or hepatobiliary cancer often is accompanied by findings of biliary obstruction. Malignant biliary obstruction frequently is associated with pruritus, anorexia, cholangitis, or hyperbilirubinemia, which that precludes treatment with chemotherapeutic agents that are excreted or metabolized hepatically. In patients with low biliary obstruction, endoscopic stent placement may accomplish drainage of the entire biliary tree without the need for an external device. Patients with high bile duct obstruction, on the other hand, may need a percutaneous approach to drain the target ducts and avoid draining an atrophic segment or lobe. This first of a series of two articles concerning palliative percutaneous biliary intervention will review the indications for biliary drainage and the preprocedure evaluation of this complicated patient population.
肝转移、肝门周围淋巴结肿大或肝胆癌的诊断通常伴有胆道梗阻的表现。恶性胆道梗阻常伴有瘙痒、厌食、胆管炎或高胆红素血症，这使得经肝脏排泄或代谢的化疗药物无法使用。对于低位胆道梗阻患者，内镜支架置入术可实现整个胆道树的引流，无需外部装置。另一方面，高位胆管梗阻患者可能需要经皮途径引流目标胆管，避免引流萎缩的节段或肝叶。这两篇关于姑息性经皮胆道介入的系列文章中的第一篇将回顾胆道引流的适应证以及对这类复杂患者群体的术前评估。
