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门静脉海绵样变性相关性胆管病:诊断与管理的最新进展及建议

Portal cavernoma cholangiopathy: Update and recommendations on diagnosis and management.

作者信息

Bhavsar Ruchir, Yadav Amitabh, Nundy Samiran

机构信息

Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India.

出版信息

Ann Hepatobiliary Pancreat Surg. 2022 Nov 30;26(4):298-307. doi: 10.14701/ahbps.22-029. Epub 2022 Sep 28.

Abstract

Portal cavernoma cholangiopathy is defined as an obstruction of the biliary system due to distended veins surrounding bile ducts that mainly occur in patients with extrahepatic portal venous obstruction. The periductal venous plexuses encircling the ducts can cause morphological changes which may or may not become symptomatic. Currently, non-invasive techniques such as ultrasonography, computed tomography, magnetic resonance cholangiopancreatography, and dynamic contrast enhanced magnetic resonance images are being used to diagnose this disorder. Only a few patients who have symptoms of biliary obstruction require drainage which might be accomplished using endoscopic stenting, decompression of the portal venous system usually via a lienorenal shunt, a difficult direct hepaticojejunostomy, and rarely a liver transplant.

摘要

门静脉海绵样变性胆管病的定义为

由于主要发生在肝外门静脉阻塞患者中的围绕胆管的扩张静脉导致的胆道系统梗阻。环绕胆管的导管周围静脉丛可引起形态学改变,这些改变可能有症状,也可能没有症状。目前,超声、计算机断层扫描、磁共振胰胆管造影和动态对比增强磁共振成像等非侵入性技术正被用于诊断这种疾病。只有少数有胆道梗阻症状的患者需要引流,这可能通过内镜支架置入术、通常经脾肾分流的门静脉系统减压、困难的直接肝空肠吻合术来完成,很少需要进行肝移植。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddb9/9721250/980d772fa257/ahbps-26-4-298-f1.jpg

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