Dorrell Robert, Pawa Swati, Pawa Rishi
Department of Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA.
Department of Medicine, Division of Gastroenterology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
Diagnostics (Basel). 2020 Jun 10;10(6):390. doi: 10.3390/diagnostics10060390.
A biliary stricture is an area of narrowing in the extrahepatic or intrahepatic biliary system. The majority of biliary strictures are caused by malignancies, particularly cholangiocarcinoma and pancreatic adenocarcinoma. Most malignant biliary strictures are unresectable at diagnosis. Treatment of these diseases historically required surgical procedures, however, the development of endoscopic techniques has provided alternative minimally invasive treatment options to improve patient quality of life and survival with unresectable disease. While endoscopic retrograde cholangiopancreatography with stent placement has been the cornerstone of biliary drainage for decades, cutting edge endoscopic developments, including radiofrequency ablation and endoscopic ultrasound-guided biliary drainage, offer new therapy options to patients that historically have a poor quality of life and a grim prognosis. In this review, we explore the endoscopic techniques that have contributed to revolutionary advancements in the endoscopic management of malignant biliary strictures.
胆管狭窄是肝外或肝内胆管系统的狭窄区域。大多数胆管狭窄由恶性肿瘤引起，尤其是胆管癌和胰腺腺癌。大多数恶性胆管狭窄在诊断时无法切除。这些疾病的治疗过去需要外科手术，然而，内镜技术的发展提供了替代性的微创治疗选择，以改善无法切除疾病患者的生活质量和生存率。虽然几十年来内镜逆行胰胆管造影术加支架置入一直是胆管引流的基石，但包括射频消融和内镜超声引导下胆管引流在内的前沿内镜技术发展，为过去生活质量差、预后不佳的患者提供了新的治疗选择。在本综述中，我们探讨了在内镜治疗恶性胆管狭窄方面带来革命性进展的内镜技术。
