基于临床病理特征的局限性肝内胆管狭窄的诊治思考  

Discussions on the diagnosis-treatment of focal intrahepatic bile duct strictures based on its pathological characteristics

作　　者：周迪[1] 庄鹏远[1] 沈军[1] 王健东[1] Zhou Di;Zhuang Pengyuan;Shen Jun;Wang Jiandong(Department of General Surgery,Xinhua Hospital Affiliated to Shanghai Jiao Tong University,School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院普外科,上海200092

出　　处：《中华肝胆外科杂志》2021年第5期321-325,共5页Chinese Journal of Hepatobiliary Surgery

基　　金：上海交通大学医工交叉课题(YG2017MS74)。

摘　　要：局限性肝内胆管狭窄(FIHS)是指由于各种因素引起的肝内胆管局限性狭窄。FIHS较为罕见,极易误诊、漏诊。目前,各种检查技术在FIHS的定位和定性诊断方面均有灵敏度差的缺陷。注重病史、联合运用各种检查手段有助于提高FIHS的诊断水平。治疗上,建议通过内镜技术对可疑恶变以及内科治疗无效的FIHS进行狭窄扩张、胆道引流和病理学诊断,在此基础上依据FIHS的解剖学分型确定手术的指征和方式。Focal intrahepatic strictures(FIHS)refers to local strictures or stenosis of the intrahepatic bile duct induced by various factors.FIHS is easily leading to misdiagnosis and miss diagnosis.At present,most of the techniques or examinations for making position as well as qualitative diagnosis of FIHS have poor sensitivity.Paying more attention to the medical history and combined applications of various inspection methods might help to improve the diagnostic level of FIHS.In terms of treatment,we suggested for patients with suspected malignant strictures or those who were failure of medical treatment,dilation,drainage and pathological diagnosis of FIHS could be conducted by endoscopy before determining the indications and procedures of surgery based on a new anatomy classification system of FIHS.

关 键 词：胆管 狭窄 定位诊断 定性诊断 分型 

分 类 号：R657.4[医药卫生—外科学]