Staging of Biliary Carcinoma: Cholangiography and Cholangioscopy
Staging of Biliary Carcinoma: Cholangiography and Cholangioscopy
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胆道癌的分期：胆管造影和胆管镜检查
作者：
Y. Nimura
胆道肿瘤通常可以通过传统的胆管造影术诊断，通过内窥镜逆行胰胆管造影术（ERCP）或经皮经鞘胆管造影术（PTC）。然而，这些程序并不能精确地描绘肝内胆管的节段解剖结构和癌扩散到胆管壁的程度。自1975年以来，我们一直使用选择性胆管造影经皮经鞘管胆道引流（PTBD）和经皮经鞘管胆道镜（PTCS）的帮助下，以实现准确的术前诊断肿瘤的蔓延。在501例恶性病例中进行了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。PTCS为胆道癌的术前诊断和分期提供了额外的诊断优势。PTBD和PTCS的发病率和死亡率分别为9%和0%。
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.