病例报告：不明原因胆管狭窄的诊断困境：两例报告并文献复习
Case report: The diagnostic dilemma of indeterminate biliary strictures: report on two cases with a literature review.
作者信息
Meng Chunyan, Wang Jing, Zhang Peipei, Wang Bo
机构信息
Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Health Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
出版信息
Front Oncol. 2024 Mar 27;14:1301937. doi: 10.3389/fonc.2024.1301937. eCollection 2024.
BACKGROUND
It is still a challenging problem for clinicians to explore the nature of the indeterminate biliary strictures (IBSs). Approximately 20% of biliary strictures remain undetermined after a thorough preoperative assessment.
CASE PRESENTATION
Here, we present two cases of indeterminate biliary strictures patients, whose cross- sectional imaging and endoscopic examination were nondiagnostic. The patients underwent exploratory laparotomy finally and were confirmed as malignancy. We also reviewed the recent reports in literatures regarding the evaluation of IBSs.
CONCLUSIONS
Given the majority of the biliary strictures are malignancy, preoperative differentiation between benign and malignant is critical for choosing the best therapeutic regimen. Thus, close follow-up, multiple multidisciplinary discussion, and prompt surgical exploration are necessary for some difficult diagnostic cases.
背景
对于临床医生而言，探究不明确的胆管狭窄（IBSs）的性质仍是一个具有挑战性的问题。在全面的术前评估后，约20%的胆管狭窄仍无法明确。
病例报告
在此，我们展示两例不明确胆管狭窄患者的病例，其横断面成像和内镜检查均无法确诊。患者最终接受了剖腹探查术，并被确诊为恶性肿瘤。我们还回顾了近期文献中有关IBSs评估的报道。
结论
鉴于大多数胆管狭窄为恶性，术前区分良恶性对于选择最佳治疗方案至关重要。因此，对于一些诊断困难的病例，密切随访、多次多学科讨论以及及时的手术探查是必要的。
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