内镜胆道引流术治疗胰腺癌引起的远端胆管阻塞。

IF 2.1 Q3 GASTROENTEROLOGY & HEPATOLOGY
Masahiro Itonaga, Masayuki Kitano
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引用次数: 0

摘要

大约 60% 的胰腺癌发生在胰腺头部,可能会因胆管受侵而出现梗阻性黄疸。梗阻性黄疸往往导致全身状况不佳和急性胆管炎,影响手术和化疗,需要进行胆道引流。胆道引流的首选治疗方法是内镜下经胆管引流术。对于无法切除的肿瘤,最常用的是自膨胀金属支架(SEMS),分为无盖金属支架和有盖金属支架。最近,抗流金属支架和大口径或小口径的 SEMS 已可在市场上买到,其实用性也有报道。塑料支架很少用于可切除胆道梗阻的患者;然而,由于近年来术前化疗的趋势,SEMS 因其复发胆道梗阻的时间较长而被频繁使用。内镜超声引导下胆道引流术(EUS-BD)通常用于不适合采用经胆道方法的患者,并且有报道称其疗效良好。目前已开发出不同的 EUS-BD 技术和专用支架,可在大容量中心安全使用。预计未来 EUS-BD 的适应症将进一步扩大。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Endoscopic biliary drainage for distal bile duct obstruction due to pancreatic cancer.

Approximately 60% of pancreatic cancers occur in the pancreatic head and may present as obstructive jaundice due to bile duct invasion. Obstructive jaundice often leads to poor general conditions and acute cholangitis, interfering with surgery and chemotherapy and requiring biliary drainage. The first choice of treatment for biliary drainage is the endoscopic transpapillary approach. In unresectable tumors, self-expandable metal stents (SEMSs) are most commonly used and are classified into uncovered and covered SEMSs. Recently, antireflux metal stents and large- or small-diameter SEMSs have become commercially available, and their usefulness has been reported. Plastic stents are infrequently used in patients with resectable biliary obstruction; however, owing to the recent trend in preoperative chemotherapy, SEMSs are frequently used because of the long time to recurrent biliary obstruction. Endoscopic ultrasound-guided biliary drainage (EUS-BD) is often performed in patients who are not eligible for the transpapillary approach, and favorable outcomes have been reported. Different EUS-BD techniques and specialized stents have been developed and can be safely used in high-volume centers. The indications for EUS-BD are expected to further expand in the future.

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来源期刊
Clinical Endoscopy
Clinical Endoscopy GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
4.40
自引率
8.00%
发文量
95
审稿时长
26 weeks
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