肝门部胆管癌术前减黄临床意义  

The clinical implications of preoperative biliary drainage in hilar cholangiocarcinoma patients

作　　者：程石[1] 赵修浩 Cheng Shi;Zhao Xiuhao(Department of General Surgery,Affiliated Beijing Tiantan Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京天坛医院普外科

出　　处：《腹部外科》2019年第5期319-323,共5页Journal of Abdominal Surgery

摘　　要：肝门部胆管癌起病隐匿,恶性程度高,诊断时多为中晚期且常合并严重的梗阻性黄疸。术前减黄(preoperative biliary drainage,PBD)理论上可降低手术风险,提高根治性切除率,降低术后并发症发生率。目前常用术前减黄方法包括经皮经肝选择性胆管引流、内镜下胆道支架引流术(endoscopic biliary stenting,EBS)、内镜下鼻胆管引流术(endoscopic nasobiliary drainage,ENBD)3种。但因PBD可能增加胆管炎、胰腺炎等并发症,延长术前住院时间,且不能明确改善病人预后,关于肝门胆管癌是否应行PBD争议不断。Hilar cholangiocarcinoma(HC)has an insidious onset and a high degree of malignancy.Patients who was diagnosed as HC are mostly in an advanced stage at the time of diagnosis with severe obstructive jaundice.Preoperative biliary drainage(PBD)theoretically reduces the risk of surgery,increases the rate of radical resection,and reduces the incidence of postoperative complications.Currently,three methods of preoperative yellow reduction are commonly used,including percutaneous transhepatic biliary drainage(PTBD),endoscopic biliary stenting(EBS),and endoscopic nasobiliary drainage(ENBD).However,PBD may increase the complications of cholangitis,pancreatitis,etc.,prolong the preoperative hospital stay,and can not definitely improve the prognosis of patients,controversy continues on whether PBD should be performed for hilar cholangiocarcinoma.

关 键 词：肝门部胆管癌 术前减黄 

分 类 号：R657.3[医药卫生—外科学]