Herr Allen, Collins Daniel, White Mark, Mandato Kenneth, Keating Lawrence, Stark Christopher, Lee Hwajeong, Siskin Gary
Department of Radiology, Albany Medical Center, Albany, NY.
Department of Radiology, Albany Medical Center, Albany, NY.
Tech Vasc Interv Radiol. 2019 Sep;22(3):127-134. doi: 10.1053/j.tvir.2019.04.004. Epub 2019 May 2.
Intraductal biliary stones can result in significant acute and long-term complications. When patients' anatomy precludes more traditional management, the interventional radiologist may be called upon to provide well-established techniques for percutaneous biliary drainage and stone removal. This can be particularly challenging when the patient has excessively mobile, impacted, large or multiple stones. Percutaneous biliary endoscopy with adjunct interventional techniques can successfully treat these patients avoiding the patient dreaded "tube for life" scenario. Direct percutaneous visualization of the biliary tree can also diagnose and provide symptomatic relief for stone-mimicking pathologic conditions such as biliary tumors. This article will review the role, technique, and considerations for percutaneous biliary endoscopy and adjunct interventions in patients with isolated and complex, biliary stone disease and stone-mimicking pathologies.
胆管内结石可导致严重的急性和长期并发症。当患者的解剖结构不适合更传统的治疗方法时，可能会要求介入放射科医生提供成熟的经皮胆道引流和取石技术。当患者的结石活动度大、嵌顿、体积大或数量多时，这一过程尤其具有挑战性。采用辅助介入技术的经皮胆道内镜检查能够成功治疗这些患者，避免患者面临令人恐惧的“终身带管”情况。对胆道树进行直接经皮可视化检查还能够诊断并缓解类似结石的病理状况（如胆管肿瘤）所引起的症状。本文将综述经皮胆道内镜检查及辅助干预措施在孤立性和复杂性胆管结石病以及类似结石的病变患者中的作用、技术及注意事项。
