Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China.
Key Laboratory of Carcinogenesis and Cancer Invasion (Ministry of Education), Department of Liver Surgery and Transplantation, Zhongshan Hospital, Liver Cancer Institute, Fudan University, Shanghai, 200032, China.
Abdom Radiol (NY). 2021 Jan;46(1):351-361. doi: 10.1007/s00261-020-02593-5.
Malignant biliary obstruction (MBO), result of pancreatobiliary diseases is a challenging condition. Most patients with MBO are inoperable at the time of diagnosis, and the disease is poorly controlled using external-beam radiotherapy and chemotherapy. Biliary stent therapy emerged as a promising strategy for alleviating MBO and prolonging life. However, physicians find it difficult to determine the optimal type of biliary stent for the palliation of MBO. Here, we review the safety and efficacy of available biliary stents, used alone or in combination with brachytherapy, photodynamic therapy and advanced chemotherapeutics, in patients with pancreatobiliary malignancies and put forward countermeasures involving stent obstruction. Furthermore, 3D-printing stents and nanoparticle-loaded stents have broad application prospects for fabricating tailor-made biliary stents.
恶性胆道梗阻(MBO)是由胰胆疾病引起的一种具有挑战性的疾病。大多数 MBO 患者在诊断时无法进行手术,并且使用外照射放疗和化疗难以有效控制病情。胆道支架治疗作为缓解 MBO 和延长生命的一种有前途的策略已经出现。然而,医生发现很难确定用于缓解 MBO 的最佳类型的胆道支架。在这里,我们回顾了单独使用或与近距离放射治疗、光动力疗法和先进化疗联合使用的各种胆道支架在胰胆恶性肿瘤患者中的安全性和有效性,并提出了涉及支架阻塞的对策。此外,3D 打印支架和载药纳米颗粒支架在制造定制胆道支架方面具有广阔的应用前景。