内镜治疗恶性胆道梗阻的应用现状  

Research progress of endoscopic treatment for malignant biliary obstruction

作　　者：李越[1] 何南[1] 曹良启[1] 

机构地区：[1]广州医科大学附属第二医院肝胆外科,510260

出　　处：《中华普通外科学文献（电子版）》2017年第1期56-60,共5页Chinese Archives of General Surgery(Electronic Edition)

基　　金：广东省科技计划项目(2014A020212326);广东省自然基金资助项目(2015A030313466)

摘　　要：恶性胆道梗阻是由胆道或其他转移性恶性肿瘤所致的胆道梗阻性疾病,主要以梗阻性黄疸、胆管扩张、肝损伤为其临床表现,后期患者肝功能恶化,容易合并急性梗阻性化脓性胆管炎及肾衰竭等病症,大部分患者就医时已为晚期,失去手术机会。经内镜逆行胰胆管造影(ERCP)内镜下放置鼻胆管引流、支架以及胆道腔内射频消融、内镜下光动力治疗等作为姑息性微创治疗手段,已在临床上广泛开展,而且与经皮肝穿刺胆管引流术(PTCD)相比,ERCP具有患者痛苦少、操作相对简单等优点。本文整理相关文献,综述经ERCP内镜下解除恶性胆道梗阻的主要方法及其研究现状。Malignant biliary obstruction is caused by biliary or other metastatic malignant tumors, mainly with obstruction jaundice, bile duct dilatation, and liver damage as its clinical presentation. In later period, patients are characterized with deterioration of liver function, easily combined with acute obstructive and suppurative cholangitis and kidney function exhaustion. Most of the patients are late for medical treatment and lose the chance of operation. The endoscopic retrograde cholangiopancreatography（ERCP）, a palliative minimally invasive treatment, has endoscopic nasobiliary drainage and stents, intraductal radiofrequency, endoscopic photodynamic therapy, and been carried out widely. Compared with percutaneous transhepatic catheter drainage（PTCD）, ERCP has advantages of less pain and simpler operation. In this paper, the main methods and research progress of ERCP in relieving malignant biliary obstruction are reviewed.

关 键 词：胆汁淤积 胰胆管造影术 内窥镜逆行 胆道梗阻 胆管支架 

分 类 号：R730.5[医药卫生—肿瘤]