Lynn R B, Wilson J A, Cho K J
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109.
Dig Dis Sci. 1988 May;33(5):587-91. doi: 10.1007/BF01798361.
Exploratory laparotomy is frequently used to diagnose, treat, or palliate cholangiocarcinoma although surgery is rarely curative. In light of newly developed percutaneous and endoscopic approaches to diagnosis and therapy, we reviewed our experience with 35 cases of cholangiocarcinoma diagnosed and treated at the University of Michigan Medical Center from 1979 to 1984. Percutaneous transhepatic cholangiography (PTCA) was performed in 34 cases of which only four were resectable. All 22 patients who had preoperative cholangiograms suggesting unresectability had confirmation of this at surgery. Surgical palliation was accomplished with a combination of internal and percutaneous drainage in most cases. Angiographic, cytologic, and laboratory data are presented. PTCA accurately predicted unresectability of cholangiocarcinoma and is superior to angiography in this respect. In patients with cholangiocarcinoma, percutaneous and endoscopic approaches offer alternatives to surgery for diagnosis and palliation.
尽管手术很少能治愈胆管癌，但剖腹探查术仍经常用于诊断、治疗或缓解胆管癌。鉴于新出现的经皮和内镜诊断及治疗方法，我们回顾了1979年至1984年在密歇根大学医学中心诊断和治疗的35例胆管癌患者的经验。34例患者接受了经皮肝穿刺胆管造影（PTCA），其中只有4例可切除。所有22例术前胆管造影提示不可切除的患者在手术中均得到证实。在大多数情况下，通过内引流和经皮引流相结合的方式实现了手术姑息治疗。文中还给出了血管造影、细胞学和实验室数据。PTCA能准确预测胆管癌的不可切除性，在这方面优于血管造影。对于胆管癌患者，经皮和内镜方法为诊断和姑息治疗提供了手术之外的替代方案。
