Gerges Christian, Schumacher Brigitte, Terheggen Grischa, Neuhaus Horst
Department of Internal Medicine, Evangelisches Krankenhaus Düsseldorf, Kirchfeldstraße 40, 40217 Duesseldorf, Germany.
Gastrointest Endosc Clin N Am. 2011 Jul;21(3):481-97, ix. doi: 10.1016/j.giec.2011.04.004.
Most patients with malignant hilar stenoses are candidates for palliation. For this purpose, biliary drainage plays a major role in improving liver function and managing or avoiding cholangitis. Endoscopic interventions are less invasive than the percutaneous approach and should be considered as the first-line drainage procedures in most cases. Transhepatic interventions should be reserved for endoscopic failures or performed as a complementary approach in a combined procedure. After successful endoscopic access to biliary obstruction, implantation of self-expandable metal stents offers advantages over plastic endoprostheses in terms of stent patency and number of reinterventions.
大多数恶性肝门部狭窄患者适合进行姑息治疗。为此，胆道引流在改善肝功能以及控制或避免胆管炎方面发挥着主要作用。内镜干预的侵入性低于经皮途径，在大多数情况下应被视为一线引流方法。经肝干预应留作内镜治疗失败时使用，或作为联合治疗中的一种补充方法。在内镜成功打通胆道梗阻后，就支架通畅性和再次干预次数而言，植入自膨式金属支架比塑料内支架更具优势。
