Costamagna Guido, Familiari Pietro, Iacopini Federico, Shah Syed, Marchese Miechele
Digestive Endoscopy Unit, Catholic University, Roma, Italia.
Rev Gastroenterol Mex. 2005 Jul;70 Suppl 1:63-82.
Almost all biliary diseases are now amenable to endoscopic treatment. Progress in therapeutic biliary endoscopy is currently focusing on identifying the best treatment options to be used in each case in relation to available evidence: how should a malignant stricture of the common bile duct or hilium be drained? How should a "difficult" biliary stone be extracted? How should an external biliary fistula be treated? What should one do with the gallbladder after extraction of common bile duct stone? Should sedation or general anesthesia be offered? Progress has been made in the technique of endoscopic ampulectomy and in developing new devices to improve the success rate of endoscopic retrograde cholangiopancreatography.
如今，几乎所有胆道疾病都适合内镜治疗。治疗性胆道内镜的进展目前集中在根据现有证据确定针对每种情况的最佳治疗方案：胆总管或肝门部恶性狭窄应如何引流？“困难”的胆管结石应如何取出？外源性胆瘘应如何治疗？取出胆总管结石后胆囊应如何处理？应采用镇静还是全身麻醉？内镜下切除术技术以及开发提高内镜逆行胰胆管造影成功率的新设备都取得了进展。
