胆道狭窄内镜外科诊治现状与进展  

Current status and progress in the endoscopic surgical management of biliary strictures

作　　者：仲富鹏 岳平[1,2,3,4,5,6] 李汛[1,2,3,4,5,6] ZHONG Fupeng;YUE Ping;LI Xun(The First School of Clinical Medicine,Lanzhou University,Lanzhou 730030,China;Department of General Surgery,the First Hospital of Lanzhou University,Lanzhou 730030,China;Key Laboratory Biotherapy and Regenerative Medicine of Gansu Province,Lanzhou 730030,China;Cancer Prevention and Treatment Center of Lanzhou University School of Medicine,Lanzhou 730030,China;Hepatopancreatobiliary Surgery Institute of Gansu Province,Lanzhou 730030,China;Clinical Research Center for General Surgery of Gansu Province,Lanzhou 730030,China)

机构地区：[1]兰州大学第一临床医学院,甘肃兰州730030 [2]兰州大学第一医院普通外科,甘肃兰州730030 [3]甘肃省生物治疗与再生医学重点实验室,甘肃兰州730030 [4]兰州大学医学院肿瘤防治中心,甘肃兰州730030 [5]甘肃省肝胆胰外科研究所,甘肃兰州730030 [6]甘肃省普通外科临床医学研究中心,甘肃兰州730030

出　　处：《中国普通外科杂志》2025年第2期229-237,共9页China Journal of General Surgery

基　　金：甘肃省科技厅科技重大专项国际合作领域基金资助项目(23ZDWA003);甘肃省科技厅创新基础和人才基金资助项目(20JR10FA661)。

摘　　要：胆道外科的历史悠久,胆道狭窄作为其中常见的临床问题,主要包括良性狭窄、恶性狭窄以及不明原因的狭窄。胆道狭窄的性质直接决定治疗方式,对于CT和MRCP/MRI难以明确性质的狭窄,ERCP、超声内镜及其相关技术是诊断和治疗的重要手段,共聚焦激光显微内镜、光学相干断层成像术、二代测序等技术的兴起丰富了胆道狭窄的诊治手段。同时掌握内镜技术和外科手术的内镜外科医生或诊疗团队,在处理复杂解剖结构、可切除胆道肿瘤等胆道狭窄问题上具有独特的优势。尽管胆道外科近年来在内镜技术、外科手术等诊疗方面有了长足发展,但仍存在一些亟待解决的问题,笔者就胆道狭窄的内镜外科诊治现状、进展及存在的问题进行评述,以期为临床工作提供参考。Biliary surgery has a long history,with biliary strictures being a common clinical issue in this field.These strictures primarily include benign strictures,malignant strictures,and biliary strictures of unknown etiology.The nature of the biliary stricture directly determines the treatment approach.For strictures that are difficult to characterize with CT and MRCP/MRI,endoscopic ultrasound,and related technologies are important tools for the diagnosis and treatment.The rise of technologies such as confocal laser endomicroscopy,optical coherence tomography,and next-generation sequencing has expanded the diagnostic and therapeutic options for biliary strictures.Furthermore,endoscopic surgeons or treatment teams who are proficient in both endoscopic techniques and surgical procedures have unique strengths when dealing with complex anatomical structures or resectable biliary tumors.Although significant advancements have been made in biliary surgery in recent years,particularly in endoscopic technology,surgical techniques,and diagnostic methods,several challenges still remain to be addressed.Here,the authors provide a review of the current status,advancements,and challenges in the endoscopic surgical treatment of biliary strictures,with the aim of offering insights for clinical practice.

关 键 词：胆道疾病 缩窄 病理性 胰胆管造影术 内窥镜逆行 腔内超声检查 

分 类 号：R575.7[医药卫生—消化系统]