Memorial Sloan Kettering Cancer Center, 1275 York Avenue, H-118, New York, NY 10065, USA.
Memorial Sloan Kettering Cancer Center, Weill Cornell Medical Center, 1275 York Avenue, H-118, New York, NY 10065, USA.
Gastroenterol Clin North Am. 2018 Sep;47(3):621-641. doi: 10.1016/j.gtc.2018.04.008. Epub 2018 Jul 7.
Biliary drainage is important in the care of patients with benign and malignant biliary obstruction. Careful preprocedure evaluation of high-quality cross-sectional imaging and inventory of symptoms are necessary to determine whether a percutaneous, endoscopic, or surgical approach is most appropriate. High bile duct obstruction is usually best managed percutaneously; a specific duct can be targeted and enteric contamination of isolated ducts can be avoided. Options for percutaneous biliary intervention include external or internal/external biliary drainage, stent placement, biliary stone retrieval, and bile duct biopsy. Preprocedure evaluation, technique, and indications for percutaneous intervention in benign and malignant diseases are summarized.
胆道引流在治疗良性和恶性胆道梗阻患者中很重要。在确定最适合采用经皮、内镜还是手术方法之前，需要仔细地对高质量的横断面成像进行术前评估，并列出症状清单。高位胆管梗阻通常最好采用经皮方法治疗；可以靶向特定的胆管，并避免孤立胆管的肠液污染。经皮胆道介入的选择包括外引流或内外引流、支架置入、胆管取石和胆管活检。本文总结了良性和恶性疾病的经皮介入术前评估、技术和适应证。
