Barinagarrementeria Ricardo
Departamento de Endoscopia Digestiva, Hospital Angeles del Pedregal, México, D.F.
Rev Gastroenterol Mex. 2005 Jul;70 Suppl 1:95-106.
The diagnosis of bilio-pancreatic diseases is carried out when patients present symptoms of biliary obstruction. The majority of these patients cannot receive curative treatment at the time of the diagnosis. Laboratory tests can differentiate between intra- or extra-hepatic obstruction, and the different imaging techniques will establish the cause and degree of disease extension. Endoscopic cholangiography can confirm the tumor's etiology with a biopsy, cytology or aspiration at the level of the stenosis. Palliative endoscopic treatment offers good results. The decision of placing a plastic or metallic stent will depend on the probable survival rate that the patient has. In tumors in the hila a previous magnetic resonance cholangiography plays a fundamental role in the therapeutic decision.
当患者出现胆道梗阻症状时,会对胆胰疾病进行诊断。这些患者中的大多数在诊断时无法接受根治性治疗。实验室检查可区分肝内或肝外梗阻,不同的影像学技术将确定疾病的病因和扩展程度。内镜胆管造影可通过在狭窄部位进行活检、细胞学检查或抽吸来确诊肿瘤病因。姑息性内镜治疗效果良好。放置塑料或金属支架的决定将取决于患者可能的生存率。对于肝门部肿瘤,术前磁共振胆胰管造影在治疗决策中起着重要作用。