Moreira V F, Meroño E, San Román A L, Pérez F, Erdozain J C, Sánchez-Ruano J J, Bárcena R
Servicio de Gastroenterología, Hospital Ramón y Cajal, Madrid.
Rev Clin Esp. 1990 May;186(9):430-5.
We have been interested in demonstrating the usefulness of the reverse endoscopic cholangiopancreatography, a technique already accepted in extrahepatic biliary pathology and the cholangiocarcinoma diagnosis. First of all we reviewed those cases diagnosed as cholangiocarcinoma using the REC and we found that only in 14 (60.9%) of a total of 23 cases the diagnosis was confirmed by surgery, resulting in a false positive ratio of 39.1%. In the second analysis of 22 patients who underwent surgery and whose surgical diagnosis was cholangiocarcinoma, we confirmed a correct presurgery diagnosis by REC in 14 (63.6%) with a false negative ratio of 36.3% which could be reduced to 26.3% after excluding the technically incorrect explorations or those in which only the pancreatic ductus was visualized. We conclude that cholangiocarcinoma diagnosis by REC has a high false positive or negative ratio, thus, treatment, specially non surgical, of a possibly malignant stenosis or obstruction of the bile duct can not only be based on choleangiopatic findings.
我们一直致力于证明逆行内镜胰胆管造影术（reverse endoscopic cholangiopancreatography，REC）的实用性，该技术已被用于肝外胆管疾病及胆管癌的诊断。首先，我们回顾了那些通过REC诊断为胆管癌的病例，发现在总共23例病例中，只有14例（60.9%）经手术确诊，假阳性率为39.1%。在对22例行手术且手术诊断为胆管癌的患者进行的第二项分析中，我们通过REC在14例（63.6%）患者中证实了术前诊断正确，假阴性率为36.3%，排除技术操作不当或仅观察到胰管的病例后，该假阴性率可降至26.3%。我们得出结论，REC诊断胆管癌的假阳性或假阴性率较高，因此，对于可能为恶性的胆管狭窄或梗阻的治疗，尤其是非手术治疗，不能仅基于胆管造影的结果。
