Sakai Yuji, Tsuyuguchi Toshio, Tsuchiya Shin, Fukuda Yoshihiro, Miyakawa Kaoru, Sugiyama Harutoshi, Asano Kohjiro, Ohtsuka Masayuki, Miyazaki Masaru, Yokosuka Osamu
Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba City, Japan.
Hepatogastroenterology. 2008 Sep-Oct;55(86-87):1509-12.
BACKGROUND/AIMS: The purpose of this study was to examine the clinical utility of peroral cholangioscopy for mucin-producing bile duct tumor.
Peroral cholangioscopy was performed in seven cases of mucin-producing bile duct tumor to decide the course of treatment based on the results. All seven cases were evaluated by peroral cholangioscopy and examined by a transpapillary biopsy. Five out of the seven cases (71.4%) were adequately observed. Because abundant mucin could not be removed in 2 cases (28.6%), one of them underwent PTCS after PTBD, and the other had surgery for EBD insertion without PTBD at the patient's request. A stent was placed by surgery in five out of the seven cases and by a transpapillary method in two cases.
Among the five cases that could be evaluated by peroral cholangioscopy, the excised specimens were compared with the findings obtained from peroral cholangioscopy in three cases that underwent surgery, while the results of transpapillary mapping biopsy were compared with the findings obtained from peroral cholangioscopy in two inoperable cases, showing that the evaluation by peroral cholangioscopy agreed with the results of tumor staging in all the five cases.
This study suggested the possibility that the use of peroral cholangioscopy for mucin-producing bile duct tumor could be useful in deciding the course of treatment.
背景/目的:本研究旨在探讨经口胆管镜检查在黏液性胆管肿瘤中的临床应用价值。
对7例黏液性胆管肿瘤患者进行经口胆管镜检查,并根据检查结果确定治疗方案。所有7例患者均接受了经口胆管镜检查,并进行了经乳头活检。7例中有5例(71.4%)观察充分。2例(28.6%)因黏液过多无法清除,其中1例在经皮经肝胆道引流(PTBD)后接受了经皮经肝胆道镜检查(PTCS),另1例根据患者要求未行PTBD直接接受了内镜下胆管引流(EBD)置入手术。7例中有5例通过手术置入支架,2例通过经乳头方法置入支架。
在可通过经口胆管镜检查评估的5例患者中,对3例接受手术的患者,将切除标本与经口胆管镜检查结果进行比较;对2例无法手术的患者,将经乳头定位活检结果与经口胆管镜检查结果进行比较,结果显示经口胆管镜检查评估与所有5例患者的肿瘤分期结果一致。
本研究提示,经口胆管镜检查在黏液性胆管肿瘤治疗方案的确定中可能具有应用价值。