Liguory C, Lefebvre J F, Bonnel D
Centre médico-chirurgical de l'Alma, Paris, France.
Rev Prat. 1991 Jan 21;41(3):220-4.
Endoscopic retrograde cholangio-pancreatography (ERCP) confirms the diagnosis of obstructive jaundice and sometimes provides the histological proof that the stenosis is due to cancer. Palliative treatment of biliary and pancreatic cancers is indicated when the extension of the tumour is such that it precludes any oncologically satisfactory excision, in patients at high operative risk, when jaundice recurs after surgery and in cases of biliary metastases from distant cancers. Cancers located below the hilum are usually easily treated by endoscopic insertion of a biliary stent, whereas hilar cancers extending to the bifurcation often require combined endoscopic and percutaneous techniques to drain all liver segments. The most frequent of early complications of biliary stents is cholangitis, notably in hilar cancers. Late complications, notably obstruction of the stent, can be reduced by using expandable metal stents.
内镜逆行胰胆管造影术（ERCP）可确诊梗阻性黄疸，有时还能提供组织学证据证明狭窄是由癌症引起的。当肿瘤范围广泛以致无法进行任何肿瘤学上满意的切除时、手术风险高的患者、术后黄疸复发时以及远处癌症发生胆管转移的情况下，均需对胆管癌和胰腺癌进行姑息治疗。位于肝门以下的癌症通常通过内镜插入胆管支架很容易治疗，而延伸至分叉处的肝门癌往往需要联合内镜和经皮技术来引流所有肝段。胆管支架最常见的早期并发症是胆管炎，尤其是在肝门癌患者中。使用可扩张金属支架可减少晚期并发症，特别是支架阻塞。
