Nimura Y
First Department of Surgery, Nagoya University School of Medicine, Japan.
Endoscopy. 1993 Jan;25(1):76-80. doi: 10.1055/s-2007-1009128.
Tumors of the biliary tract can usually be diagnosed by conventional cholangiography, either via endoscopic retrograde cholangio-pancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC). However, these procedures do not precisely delineate the segmental anatomy of the intrahepatic bile duct and the extent of cancer spread into the bile duct wall. Since 1975, we have been using selective cholangiography via percutaneous transhepatic biliary drainage (PTBD) and with the aid of percutaneous transhepatic cholangioscopy (PTCS) to achieve accurate preoperative diagnosis of tumor extension. PTBD was performed in 501 malignant cases, with 295 of them undergoing PTCS; high-quality cholangiograms were obtained in all cases. PTCS offers the additional diagnostic advantage of taking biopsies for the preoperative diagnosis and staging of biliary tract cancer. The morbidity and mortality rates of PTBD and PTCS were 9% and 0%, respectively.
胆道肿瘤通常可通过传统胆管造影术进行诊断，可经内镜逆行胰胆管造影术（ERCP）或经皮肝穿刺胆管造影术（PTC）。然而，这些检查方法无法精确描绘肝内胆管的节段性解剖结构以及癌症扩散至胆管壁的范围。自1975年以来，我们一直通过经皮肝穿刺胆道引流术（PTBD）进行选择性胆管造影，并借助经皮肝穿刺胆管镜检查（PTCS）来实现对肿瘤侵犯范围的准确术前诊断。对501例恶性病例进行了PTBD，其中295例接受了PTCS；所有病例均获得了高质量的胆管造影图像。PTCS在术前诊断和胆道癌分期方面具有额外的诊断优势，即能够进行活检。PTBD和PTCS的发病率和死亡率分别为9%和0%。
