Iqbal Shahzad, Stevens Peter D
Division of Digestive and Liver Diseases, Department of Medicine, Columbia University College of Physicians and Surgeons, P&S 10-508, 630 West 168th Street, NY 10032, USA.
Gastrointest Endosc Clin N Am. 2009 Oct;19(4):567-77. doi: 10.1016/j.giec.2009.06.005.
Establishing a tissue diagnosis in patients with suspected pancreaticobiliary malignancies remains challenging. Endoscopic retrograde cholangiopancreatography (ERCP)-based sampling methods have been reviewed in a previous issue of this journal but, unfortunately, the diagnostic yield continues to be inadequate in a significant minority of patients. The availability and image quality of cholangioscopy and pancreatoscopy have advanced in the last few years and our ability to make a diagnosis on imaging alone is improving. However, a definitive diagnosis requires tissue; cholangiopancreatoscopy allows targeted biopsies of the epithelium of the biliary and pancreatic ducts. This article reviews the evidence that cholangioscopy- and pancreatoscopy-guided biopsies improves diagnostic yield over ERCP-based tissue sampling techniques.
对疑似胰胆恶性肿瘤患者进行组织诊断仍然具有挑战性。本刊上一期已对基于内镜逆行胰胆管造影（ERCP）的采样方法进行了综述，但遗憾的是，在相当一部分患者中，诊断率仍然不足。在过去几年中，胆管镜和胰管镜的可用性和图像质量有所提高，我们仅通过影像学进行诊断的能力也在改善。然而，明确诊断需要组织；胆管镜和胰管镜检查可对胆管和胰管上皮进行靶向活检。本文综述了胆管镜和胰管镜引导下活检比基于ERCP的组织采样技术能提高诊断率的证据。
