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[胆汁淤积:介入治疗]

[Cholestasis: interventional therapy].

作者信息

Ell C

机构信息

Medizinische Klinik II, Dr.-Horst-Schmidt-Kliniken, Wiesbaden.

出版信息

Praxis (Bern 1994). 1998 Nov 11;87(46):1537-41.

PMID:9857765
Abstract

Treatment of cholestasis by bile duct obstruction is nowadays dominated by endoscopy and other interventional measures. Intraductal concrements can be removed almost always without open surgery. This is as a rule achieved by a transpapillary approach with the additional use of lithothripsy. Percutaneous transhepatic treatment of concrements is restricted to patients in which a transpapillary approach is impossible. Stenoses of biliary ducts by malignancies are treated with plastic or metallic endoprosthesis if curative resection is precluded. Percutaneous drainage is a valid option in reserve. Stenosis of the papilla by scars, tumors or sphincter dysfunction are mainly treated endoscopically, malignancies--if possible--by radical surgery. Rare causes for obstruction have also to be considered. They are in most instances amenable to interventional procedures.

摘要

目前,胆管梗阻性胆汁淤积的治疗以内镜检查及其他介入措施为主。几乎总能在不进行开放手术的情况下清除导管内结石。通常通过经乳头途径并辅以碎石术来实现这一点。经皮经肝治疗结石仅限于无法采用经乳头途径的患者。如果无法进行根治性切除,恶性肿瘤导致的胆管狭窄则采用塑料或金属内支架治疗。经皮引流是备用的有效选择。瘢痕、肿瘤或括约肌功能障碍导致的乳头狭窄主要通过内镜治疗,恶性肿瘤——如果可能的话——则通过根治性手术治疗。还必须考虑罕见的梗阻原因。在大多数情况下,它们都适合采用介入治疗。

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