Weismüller J, Gail K, Seifert E
Dtsch Med Wochenschr. 1983 Feb 11;108(6):203-9. doi: 10.1055/s-2008-1069528.
A diagnosis of malignant extrahepatic biliary obstruction was made in 123 cases by endoscopic retrograde cholangio-pancreaticography (ERCP) and (or) percutaneous transhepatic cholangiography (PTC). The diagnosis was confirmed by operation, biopsy or autopsy or further investigations and follow-up. The diagnosis was correct in 96% and false in only 4%. Clinical and biochemical findings were unreliable. Ultrasound investigations were accurate in 94% of cases with malignant obstruction low down. However, it was negative in cases with high obstruction in 19% due to the absence of dilatation of the intrahepatic biliary ducts. Consequently these cases could not be diagnosed without additional ERCP and PTC. ERCP and PTC also permit palliative treatment to be done. In 30% of all cases a palliative non-surgical treatment was performed such as endoscopic sphincterotomy with or without endoprosthesis or percutaneous transhepatic drainage.
通过内镜逆行胰胆管造影术（ERCP）和（或）经皮经肝胆管造影术（PTC），确诊了123例恶性肝外胆管梗阻病例。诊断通过手术、活检或尸检或进一步检查及随访得以证实。诊断正确率为96%，误诊率仅为4%。临床和生化检查结果不可靠。超声检查对低位恶性梗阻病例的准确率为94%。然而，由于肝内胆管未扩张，高位梗阻病例中有19%的超声检查结果为阴性。因此，若无额外的ERCP和PTC检查，这些病例无法确诊。ERCP和PTC还可进行姑息治疗。在所有病例中，30%进行了姑息性非手术治疗，如内镜括约肌切开术（有或无内置假体）或经皮经肝引流术。
