Petersen Bret T
Department of Medicine, Division of Gastroenterology and Hepatology, Charlton 8, GI Endoscopy, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Gastrointest Endosc Clin N Am. 2009 Oct;19(4):579-86. doi: 10.1016/j.giec.2009.06.003.
Cholangioscopy is gaining renewed interest and gradually expanded use as a result of recent technical improvements in endoscopes and accessories, coupled with shortcomings in the accuracy of currently available techniques for biliary sampling and diagnosis. Challenging clinical dilemmas that may benefit from its application include early diagnosis of cholangiocarcinoma in the setting of primary sclerosing cholangitis, early identification of biliary infection or ischemia following orthotopic liver transplantation, and selective duct access with wires and other devices during therapeutic endoscopic retrograde cholangiopancreatography. Preliminary data suggest that cholangioscopy has significant utility in assessment and management of primary sclerosing cholangitis. Applications in posttransplant patients and for selective duct access remain minimally defined and used.
由于内窥镜及附件的近期技术改进，再加上目前可用的胆汁采样和诊断技术准确性存在不足，胆管镜检查正重新引起关注并逐渐得到更广泛应用。可能受益于其应用的具有挑战性的临床难题包括在原发性硬化性胆管炎背景下胆管癌的早期诊断、原位肝移植后早期识别胆道感染或缺血，以及在治疗性内镜逆行胰胆管造影期间使用导线和其他装置进行选择性胆管通路建立。初步数据表明，胆管镜检查在原发性硬化性胆管炎的评估和管理中具有显著作用。在移植后患者中的应用以及选择性胆管通路建立的应用仍定义和使用较少。
