使用 ENBD-CT 胆管造影评估肝周胆管癌尾状叶的胆道分支模式。

IF 3.2 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2024-09-29 DOI:10.1002/jhbp.12073

Masayuki Akita, Hiroaki Yanagimoto, Daisuke Tsugawa, Keitaro Sofue, Hidetoshi Gon, Shohei Komatsu, Hirochika Toyama, Masahiro Kido, Tetsuo Ajiki, Takumi Fukumoto

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引用次数: 0

摘要

背景：术前识别尾状胆管分支的解剖结构对于安全、完整地切除肝周胆管癌（PHC）非常重要。在本研究中，我们使用内窥镜鼻胆管引流管（ENBD）识别了这些分支：方法：2012年1月至2022年10月期间，89例疑似PHC患者通过ENBD接受了计算机断层扫描（CT）胆管造影，并对尾状胆管分支模式进行了检查。此外，还调查了 85 名未进行胆道引流的 PHC 患者的多载体原始 CT（MDCT）扫描结果。对每种方法检测到的尾状胆管分支进行了评估：结果：ENBD-CT胆管造影发现了206个尾状胆管分支（2.44个/患者），而MDCT发现了62个分支（0.78个/患者）。ENBD-CT 胆管造影显示，89 个尾状支排入左肝管（LHD），87 个排入肝后管（Bpost），30 个排入右肝管。LHD 和 Bpost 是尾状支的共同根部。一些分支（20%）穿过左右边界与对侧肝管相连，但没有与肝前管或门静脉下型 Bpost 相连：ENBD-CT胆管造影清晰显示了胆道引流后PHC患者的尾状胆管分支。

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Assessment of the biliary branching pattern of the caudate lobe in perihilar cholangiocarcinoma using ENBD-CT cholangiography.

Background: Preoperative recognition of the anatomy of caudate biliary branches is important for the safe and complete resection of perihilar cholangiocarcinoma (PHC). In the present study, we identified these branches using an endoscopic nasobiliary drainage tube (ENBD).

Methods: Between January 2012 and October 2022, 89 patients with suspected PHC underwent computed tomographic (CT) cholangiography through ENBD and caudate biliary branching patterns were examined. Multidetector raw CT (MDCT) scans on 85 patients with PHC without biliary drainage were also investigated. The caudate biliary branches detected by each modality were evaluated.

Results: ENBD-CT cholangiography detected 206 caudate branches (2.44 branches/patient), while MDCT identified 62 branches (0.78 branches/patient). ENBD-CT cholangiography showed that 89 caudate branches drained into the left hepatic duct (LHD), 87 into the posterior hepatic duct (Bpost), and 30 into the right hepatic duct. LHD and Bpost were the common roots of the caudate branches. Some branches (20%) joined the contralateral hepatic duct across the left-right border, but not the anterior hepatic duct or infraportal-type Bpost.

Conclusions: ENBD-CT cholangiography clearly showed the caudate biliary branches in patients with PHC after biliary drainage.

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来源期刊

Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY

自引率

10.00%

发文量

178

审稿时长

6-12 weeks

期刊介绍： The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.