Classen M, Hagenmüller F
Scand J Gastroenterol Suppl. 1984;102:76-83.
Endoscopic drainage of the occluded biliary system through the papilla Vateri consists of two different methods, i.e. bilio- nasal and bilio-duodenal drainage. For bilio-nasal drainage a 250-cm- long preformed polyethylene tube is placed above the stenosis to provide the flow out of the congested bile duct. This external drainage is indicated to prevent the blockade of a ductal stone after endoscopic papillotomy (EPT), to treat septic cholangitis, and to dissolve big ductal stones chemically. Insertion of a bilio-nasal probe succeeds in 95% of hte cases. Internal bilio-duodenal drainage is more difficult and succeeds in 87%, its main indication is the inoperable malignant bile duct obstruction. The value of a preoperative biliary drainage is in discussion. Internal bilio-duodenal drainage will perhaps not prolong the survival time of patients with malignant biliary obstruction but it will improve the life quality in the majority of the patients. The decrease of serum bilirubin after the implantation of the prosthesis and the localization of the tumor are of prognostic significance.
经十二指肠乳头对梗阻性胆道系统进行内镜引流有两种不同方法，即鼻胆管引流和胆肠引流。对于鼻胆管引流，将一根250厘米长的预制聚乙烯管置于狭窄上方，以使充血的胆管内胆汁流出。这种外引流适用于预防内镜下乳头切开术（EPT）后胆管结石阻塞、治疗化脓性胆管炎以及化学溶解较大胆管结石。鼻胆管置入成功率为95%。胆肠内引流更困难，成功率为87%，其主要适应证是无法手术的恶性胆管梗阻。术前胆道引流的价值仍在讨论中。胆肠内引流可能不会延长恶性胆管梗阻患者的生存时间，但会改善大多数患者的生活质量。假体植入后血清胆红素的降低以及肿瘤的定位具有预后意义。
