Crist D W, Kadir S, Cameron J L
Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland.
Surg Gynecol Obstet. 1987 Nov;165(5):421-4.
Between May 1982 and January 1986, 55 patients with strictures of the proximal part of the biliary tract have been reconstructed with Silastic (silicone rubber) transhepatic biliary stents after the preoperative percutaneous placement of Ring catheters into one or both of the hepatic ducts. Twenty-five patients had tumors of the proximal portion of the biliary tract, 19 had sclerosing cholangitis and the remaining 11 had benign strictures of the biliary tract. Ring catheters were placed into both the right and left hepatic ducts in 38 of the 55 patients. In the remaining 17 patients, a single Ring catheter was advanced beyond the stricture and into the duodenum in 50 of the 55 patients. The preoperative percutaneous placement of Ring catheters into the right and left hepatic ducts has proved to be a useful technical aide in the operative management of patients with lesions of the proximal part of the biliary tract. Having these catheters in place at the time of the operation helps significantly in dissecting the extrahepatic biliary tree and bifurcation and are subsequently used to place the transhepatic Silastic stents that are used in the reconstruction of the biliary tract.
1982年5月至1986年1月期间，55例近端胆道狭窄患者在术前经皮将环形导管置入一侧或双侧肝管后，采用硅橡胶经肝胆汁支架进行了重建。25例患者患有近端胆道肿瘤，19例患有硬化性胆管炎，其余11例患有良性胆道狭窄。55例患者中有38例的环形导管被置入左右肝管。在其余17例患者中，55例患者中有50例将单个环形导管越过狭窄部位并推进至十二指肠。术前经皮将环形导管置入左右肝管已被证明是近端胆道病变患者手术治疗中的一项有用技术辅助手段。手术时放置这些导管有助于显著解剖肝外胆道树和肝门分叉，随后用于放置经肝硅橡胶支架，用于胆道重建。
