目的 探討內(nèi)鏡下治療膽管乳頭狀瘤的價(jià)值。
方法 6例經(jīng)病理學(xué)檢查證實(shí)的膽管乳頭狀瘤患者在行“膽道探查+ T管引流術(shù)”后6~8周行膽道鏡下高頻電刀燒灼術(shù),對(duì)術(shù)后治療效果進(jìn)行評(píng)估。
結(jié)果 6例患者術(shù)后膽汁引流量逐漸增多至100~400 ml/d(平均250 ml/d),膽汁黏稠度明顯減輕,黃疸減退。術(shù)后隨訪1~3年,平均2年,3例患者術(shù)后黃疸、腹痛明顯減輕,至今無(wú)復(fù)發(fā); 2例在繼續(xù)治療中; 1例患者隨訪半年,T管引流通暢,但因嚴(yán)重肺部感染并發(fā)多器官功能衰竭死亡。
結(jié)論 內(nèi)鏡下高頻電刀燒灼治療膽管乳頭狀瘤能有效緩解患者的臨床癥狀,明顯提高患者的生存質(zhì)量。
引用本文: 牟一,胡兵,饒林強(qiáng),唐承薇. 內(nèi)鏡下治療膽管乳頭狀瘤的價(jià)值. 中國(guó)普外基礎(chǔ)與臨床雜志, 2012, 19(1): 90-92. doi: 復(fù)制
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1. | D’Abrigeon G, Blanc P, Bauret P, et al. Diagnostic and therapeutic aspects of endoscopic retrograde cholangiography in papillomatosis of the bile ducts: analysis of five cases [J].Gastrointest Endosc, 1997, 46(3): 237-243. |
2. | Lai R, Freeman ML, Mallery S. EUS in multiple biliary papillomatosis [J]. Gastrointest Endosc, 2002, 55(1): 121-125. |
3. | Meng WC, Lau WY, Choi CL, et al. Laser therapy for multiple biliary papillomatosis via choledochoscopy[ J]. Aust N Z J Surg, 1997, 67(9): 664-666. |
4. | Jazrawi SF, Nguyen D, Barnett C, et al. Novel application of intraductal argon plasma coagulation in biliary papillomatosis (with video) [J]. Gastrointest Endosc, 2009, 69(2): 372-374. |
5. | Gunvén P, Gorsetman J, Ohlsén H, et al. Six-year recurrence free survival after intraluminal iridium-192 therapy of human bilobar biliary papillomatosis. A case report [J]. Cancer,2000, 89(1): 69-73. |
6. | Bechmann LP, Hilgard P, Frilling A, et al. Successful photodynamic therapy for biliary papillomatosis: a case report [J]. World J Gastroenterol, 2008, 14(26): 4234-4237. |
7. | 焦成文, 皋嵐雅, 王堅(jiān), 等. 膽道鏡下試用電凝治療膽管乳頭狀瘤病1 例 [J]. 肝膽胰外科雜志,2008, 20(5): 369-370. |
8. | Jazrawi SF, Nguyen D, Barnett C, et al. Novel application of intraductal argon plasma coagulation in biliary papillomatosis (with video) [J]. Gastrointest Endosc, 2009, 69(2): 372-374. |
9. | Lee PS, Auyeung KM, To KF, et al. Biliary papillomatosis complicating recurrent pyogenic cholangitis[ J]. Clin Radiol,2001, 56(7): 591-593. |
10. | Okulski EG, Dolin BJ, Kandawalla NM. Intrahepatic biliary papillomatosis [J]. Arch Pathol Lab Med, 1979, 103(12): 647-649. |
11. | Ye u n g Y P, A h c h o n g K, C h u n g C K, et al. B i l i a r y papillomatosis: report of seven cases and review of English literature [J]. J Hepatobiliary Pancreat Surg, 2003, 10(5):390-395. |
12. | Lee SS, Kim MH, Lee SS, et al. Clinicopathologic review of 58 patients with biliary papillomatosis [J]. Cancer, 2004,100(4): 783-793. |
13. | Imvrios G, Papanikolaou V, Lalountas M, et al. Papillomatosis of intra-and extrahepatic biliary tree: successful treatment with liver transplantation [J]. Liver Transpl, 2007, 13(7): 1045-1048. |
14. | Wu SD, Lu CD, Lu CJ, et al. Mucin-producing intrahepatic biliary papillomatosis[ J]. Surg Today, 2010, 40(9): 845-850. |
15. | Veedfald S, Vainer B, Wettergren A. Biliary papillomatosis is a rare cause of intermittent obstructive icterus [J]. Ugeskr Laeger, 2011, 173(44): 2797-2798.[ 16] Beavers KL, Fried MW, Johnson MW, et a1. Orthotopic liver transplantation for biliary papillomatosis [J]. Liver Transpl,2001, 7(3): 264-266.[ 17] Mourra N, Hannoun L, Rousvoal G, et al. Malignant intrahepatic biliary papillomatosis associated with viral C cirrhosis [J]. Arch Pathol Lab Med, 2002, 126(3): 369-371. |
16. | Lai R, Freeman ML, Mallery S. EUS in multiple biliary papillomatosis [J]. Gastrointestinal Endoscopy, 2002, 55(1):121-125. |
- 1. D’Abrigeon G, Blanc P, Bauret P, et al. Diagnostic and therapeutic aspects of endoscopic retrograde cholangiography in papillomatosis of the bile ducts: analysis of five cases [J].Gastrointest Endosc, 1997, 46(3): 237-243.
- 2. Lai R, Freeman ML, Mallery S. EUS in multiple biliary papillomatosis [J]. Gastrointest Endosc, 2002, 55(1): 121-125.
- 3. Meng WC, Lau WY, Choi CL, et al. Laser therapy for multiple biliary papillomatosis via choledochoscopy[ J]. Aust N Z J Surg, 1997, 67(9): 664-666.
- 4. Jazrawi SF, Nguyen D, Barnett C, et al. Novel application of intraductal argon plasma coagulation in biliary papillomatosis (with video) [J]. Gastrointest Endosc, 2009, 69(2): 372-374.
- 5. Gunvén P, Gorsetman J, Ohlsén H, et al. Six-year recurrence free survival after intraluminal iridium-192 therapy of human bilobar biliary papillomatosis. A case report [J]. Cancer,2000, 89(1): 69-73.
- 6. Bechmann LP, Hilgard P, Frilling A, et al. Successful photodynamic therapy for biliary papillomatosis: a case report [J]. World J Gastroenterol, 2008, 14(26): 4234-4237.
- 7. 焦成文, 皋嵐雅, 王堅(jiān), 等. 膽道鏡下試用電凝治療膽管乳頭狀瘤病1 例 [J]. 肝膽胰外科雜志,2008, 20(5): 369-370.
- 8. Jazrawi SF, Nguyen D, Barnett C, et al. Novel application of intraductal argon plasma coagulation in biliary papillomatosis (with video) [J]. Gastrointest Endosc, 2009, 69(2): 372-374.
- 9. Lee PS, Auyeung KM, To KF, et al. Biliary papillomatosis complicating recurrent pyogenic cholangitis[ J]. Clin Radiol,2001, 56(7): 591-593.
- 10. Okulski EG, Dolin BJ, Kandawalla NM. Intrahepatic biliary papillomatosis [J]. Arch Pathol Lab Med, 1979, 103(12): 647-649.
- 11. Ye u n g Y P, A h c h o n g K, C h u n g C K, et al. B i l i a r y papillomatosis: report of seven cases and review of English literature [J]. J Hepatobiliary Pancreat Surg, 2003, 10(5):390-395.
- 12. Lee SS, Kim MH, Lee SS, et al. Clinicopathologic review of 58 patients with biliary papillomatosis [J]. Cancer, 2004,100(4): 783-793.
- 13. Imvrios G, Papanikolaou V, Lalountas M, et al. Papillomatosis of intra-and extrahepatic biliary tree: successful treatment with liver transplantation [J]. Liver Transpl, 2007, 13(7): 1045-1048.
- 14. Wu SD, Lu CD, Lu CJ, et al. Mucin-producing intrahepatic biliary papillomatosis[ J]. Surg Today, 2010, 40(9): 845-850.
- 15. Veedfald S, Vainer B, Wettergren A. Biliary papillomatosis is a rare cause of intermittent obstructive icterus [J]. Ugeskr Laeger, 2011, 173(44): 2797-2798.[ 16] Beavers KL, Fried MW, Johnson MW, et a1. Orthotopic liver transplantation for biliary papillomatosis [J]. Liver Transpl,2001, 7(3): 264-266.[ 17] Mourra N, Hannoun L, Rousvoal G, et al. Malignant intrahepatic biliary papillomatosis associated with viral C cirrhosis [J]. Arch Pathol Lab Med, 2002, 126(3): 369-371.
- 16. Lai R, Freeman ML, Mallery S. EUS in multiple biliary papillomatosis [J]. Gastrointestinal Endoscopy, 2002, 55(1):121-125.