• 哈爾濱醫(yī)科大學(xué)附屬第一醫(yī)院肝臟外科(哈爾濱 150001);

目的  總結(jié)內(nèi)鏡治療梗阻性黃疸的臨床應(yīng)用價(jià)值。
方法  復(fù)習(xí)近年來(lái)國(guó)內(nèi)、外有關(guān)內(nèi)鏡治療梗阻性黃疸方面的文獻(xiàn)并進(jìn)行綜述。
結(jié)果  內(nèi)鏡治療膽管結(jié)石和膽道手術(shù)術(shù)后膽管狹窄可以達(dá)到外科手術(shù)同樣的結(jié)果; 通過(guò)內(nèi)鏡治療可以明確膽管腫瘤和壺腹周?chē)∽兊男再|(zhì)。
結(jié)論  內(nèi)鏡是治療梗阻性黃疸安全、有效的方法。

引用本文: 王文曉,宋瑞鵬,劉連新,姜洪池. 梗阻性黃疸的內(nèi)鏡治療. 中國(guó)普外基礎(chǔ)與臨床雜志, 2010, 17(10): 1032-1034. doi: 復(fù)制

1.  Romagnuolo J, Bardou M, Rahme E, et al. Magnetic resonance cholangiopancreatography: a meta-analysis of test performance in suspected biliary disease [J]. Ann Intern Med, 2003; 139(7): 547-557.
2.  顧志漢, 徐進(jìn)康, 徐宏偉, 等.內(nèi)鏡乳頭括約肌切開(kāi)術(shù)治療胰膽管疾病236例分析 [J]. 中華消化內(nèi)鏡雜志, 2001; 18(5): 299-300.
3.  秦鳴放. 急性重癥膽管炎的內(nèi)鏡腹腔鏡聯(lián)合治療策略 [J]. 中華消化內(nèi)鏡雜志, 2007; 24(4): 304-307.
4.  李寧, 秦鳴放, 王慶, 等. ENBD在膽總管一期縫合術(shù)中的應(yīng)用價(jià)值 [J]. 中國(guó)實(shí)用外科雜志, 2003; 23(2): 108-109.
5.  王學(xué)漢, 楊能紅, 胡康, 等. 內(nèi)鏡對(duì)梗阻性黃疸的診斷價(jià)值 [J]. 中華肝膽外科雜志, 2000; 6(2): 94-95.
6.  陳建, 劉詩(shī). MRCP與ERCP對(duì)膽道梗阻性疾病的對(duì)比分析 [J]. 醫(yī)學(xué)影像學(xué)雜志, 2009; 19(1): 64-66.
7.  薛平, 陳德, 胡以則, 等.內(nèi)鏡在膽道梗阻型肝細(xì)胞性癌處理中的作用 [J]. 中國(guó)內(nèi)鏡雜志, 2001; 7(1): 22-23.
8.  Fujita N, Noda Y, Kobayashi G, et al. Histological changes at an endosonography-guided biliary drainage site: a case report [J]. World J Gastroenterol, 2007; 13(41): 5512-5515.
9.  Tarantino I, Barresi L, Repici A, et al. EUS-guided biliary drainage: a case series [J]. Endoscopy, 2008; 40(4): 336-339..
10.  Itoi T, Itokawa F, Sofuni A, Kurihara T, et al. Endoscopic ultrasound-guided choledochoduodenostomy in patients with failed endoscopic retrograde cholangiopancreatography [J]. World J Gastroenterol, 2008; 14(39): 6078-6082..
11.  鐘蕓詩(shī), 姚禮慶, 高衛(wèi)東, 等. 經(jīng)內(nèi)鏡膽道內(nèi)支撐術(shù)解除惡性梗阻性黃疸的臨床應(yīng)用評(píng)價(jià) [J]. 中國(guó)內(nèi)鏡雜志, 2003; 9(7): 1-3.
12.  Tibble JA, Cairns SR. Role of endoscopic endoprostheses in proximal malignant biliary obstruction [J]. J Hepatobiliary Pancreat Surg, 2001; 8(2): 118-123.
13.  Ferlitsch A, Oesterreicher C, Dumonceau JM, et al. Diamond stents for palliation of malignant bile duct obstruction: a prospective multicenter evaluation [J]. Endoscopy, 2001; 33(8): 645-650.
14.  薛平, 胡以則, 盧海武, 等. ERCP在肝細(xì)胞癌并膽管癌栓時(shí)的應(yīng)用 [J]. 中華消化內(nèi)鏡雜志, 2004; 21(2): 107-109.
15.  Blechacz B, Gores GJ. Cholangiocarcinoma: advances in pa-thogenesis, diagnosis, and treatment [J]. Hepatology, 2008; 48(1): 308-321.
16.  孫凱, 孫權(quán), 劉志蘇. ERCP對(duì)壺腹周?chē)┑脑缙谠\斷價(jià)值 [J]. 臨床外科雜志, 2003; 11(5): 297-298..
17.  林琪. ERCP對(duì)膽總管下段及周?chē)膊〉脑\斷價(jià)值 [J]. 中國(guó)內(nèi)鏡雜志, 2003; 9(7): 55-57..
18.  李春生, 張照輝, 張能維, 等.十二指腸乳頭旁憩室伴縮窄性乳頭炎24例臨床分析 [J]. 中華普通外科雜志, 2001; 16(9): 534-535..
19.  Ascunce G, Ribeiro A, Rocha-Lima C, et al. Single-session endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography for evaluation of pancreaticobiliary disorders [J]. Surg Endosc, 2010; 24(6): 1447-1450.
20.  Tanaka K, Kida M. Role of endoscopy in screening of early pancreatic cancer and bile duct cancer [J]. Dig Endosc, 2009; 21 Suppl 1: S97-S100.
21.  Cotton P, Williams C. Practical gastrointestinal endoscope  [M]. 4th ed. Oxford: Blackwell Science, 1996: 139-183.
22.  Judah JR, Draganov PV. Endoscopic therapy of benign biliary strictures [J]. World J Gastroenterol, 2007; 13(26): 3531-3539.
23.  Costamagna G, Pandolfi M, Mutignani M, et al. Long-term results of endoscopic management of postoperative bile duct strictures with increasing numbers of stents [J]. Gastrointest Endosc, 2001; 54(2): 162-168.
24.  Catalano MF, Linder JD, George S, et al. Treatment of symptomatic distal common bile duct stenosis secondary to chronic pancreatitis: comparison of single vs. multiple simultaneous stents [J]. Gastrointest Endosc, 2004; 60(6): 945-952.
25.  Cantù P, Hookey LC, Morales A, et al. The treatment of patients with symptomatic common bile duct stenosis secondary to chronic pancreatitis using partially covered metal stents: a pilot study [J]. Endoscopy, 2005; 37(8): 735-739..
26.  Kahaleh M, Behm B, Clarke BW, et al. Temporary placement of covered self-expandable metal stents in benign biliary strictures: a new paradigm? (with video) [J]. Gastrointest Endosc, 2008; 67(3): 446-454..
27.  Vitale GC, Tran TC, Davis BR, et al. Endoscopic management of postcholecystectomy bile duct strictures [J]. J Am Coll Surg, 2008; 206(5): 918-923.
28.  陳訓(xùn)如.普通外科微創(chuàng)技術(shù)應(yīng)用現(xiàn)狀及展望 [J].中國(guó)普外基礎(chǔ)與臨床雜志, 2005; 12(6): 533-536.
29.  Davids PH, Tanka AK, Rauwas EA, et al. Benign biliary strictures. Surgery or endoscopy? [J]. Ann Surg, 1993; 217(3): 237-243.
30.  〖JP3〗廖娟, 李榮坤, 王春暉, 等. 肝移植術(shù)后膽道并發(fā)癥的內(nèi)鏡治療 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2010; 17(4): 333-337.
31.  〖JP3〗鞠衛(wèi)強(qiáng), 何小順, 邰強(qiáng), 等. ERCP治療肝移植術(shù)后膽道并發(fā)癥的療效評(píng)價(jià) [J]. 中華消化內(nèi)鏡雜志, 2009; 26(6): 295-298.
32.  Folkers MT, Disario JA, Adler DG. Long-term complications of endoscopic biliary sphincterotomy for choledocholithiasis: a North-American perspective [J]. Am J Gastroenterol, 2009; 104(11): 2868-2869.
33.  Sugiyama M, Atomi Y. Risk factors predictive of late complications after endoscopic sphincterotomy for bile duct stones: long-term (more than 10 years) follow-up study [J]. Am J Gastroenterol, 2002; 97(11): 2763-2767.
34.  Kageoka M, Watanabe F, Maruyama Y, et al. Long-term prognosis of patients after endoscopic sphincterotomy for choledocholithiasis [J]. Dig Endosc, 2009; 21(3): 170-175.
35.  朱化剛. 有關(guān)ERCP在膽胰疾病診治中應(yīng)用的思考 [J]. 肝膽外科雜志, 2006; 14(6): 413-415.
  1. 1.  Romagnuolo J, Bardou M, Rahme E, et al. Magnetic resonance cholangiopancreatography: a meta-analysis of test performance in suspected biliary disease [J]. Ann Intern Med, 2003; 139(7): 547-557.
  2. 2.  顧志漢, 徐進(jìn)康, 徐宏偉, 等.內(nèi)鏡乳頭括約肌切開(kāi)術(shù)治療胰膽管疾病236例分析 [J]. 中華消化內(nèi)鏡雜志, 2001; 18(5): 299-300.
  3. 3.  秦鳴放. 急性重癥膽管炎的內(nèi)鏡腹腔鏡聯(lián)合治療策略 [J]. 中華消化內(nèi)鏡雜志, 2007; 24(4): 304-307.
  4. 4.  李寧, 秦鳴放, 王慶, 等. ENBD在膽總管一期縫合術(shù)中的應(yīng)用價(jià)值 [J]. 中國(guó)實(shí)用外科雜志, 2003; 23(2): 108-109.
  5. 5.  王學(xué)漢, 楊能紅, 胡康, 等. 內(nèi)鏡對(duì)梗阻性黃疸的診斷價(jià)值 [J]. 中華肝膽外科雜志, 2000; 6(2): 94-95.
  6. 6.  陳建, 劉詩(shī). MRCP與ERCP對(duì)膽道梗阻性疾病的對(duì)比分析 [J]. 醫(yī)學(xué)影像學(xué)雜志, 2009; 19(1): 64-66.
  7. 7.  薛平, 陳德, 胡以則, 等.內(nèi)鏡在膽道梗阻型肝細(xì)胞性癌處理中的作用 [J]. 中國(guó)內(nèi)鏡雜志, 2001; 7(1): 22-23.
  8. 8.  Fujita N, Noda Y, Kobayashi G, et al. Histological changes at an endosonography-guided biliary drainage site: a case report [J]. World J Gastroenterol, 2007; 13(41): 5512-5515.
  9. 9.  Tarantino I, Barresi L, Repici A, et al. EUS-guided biliary drainage: a case series [J]. Endoscopy, 2008; 40(4): 336-339..
  10. 10.  Itoi T, Itokawa F, Sofuni A, Kurihara T, et al. Endoscopic ultrasound-guided choledochoduodenostomy in patients with failed endoscopic retrograde cholangiopancreatography [J]. World J Gastroenterol, 2008; 14(39): 6078-6082..
  11. 11.  鐘蕓詩(shī), 姚禮慶, 高衛(wèi)東, 等. 經(jīng)內(nèi)鏡膽道內(nèi)支撐術(shù)解除惡性梗阻性黃疸的臨床應(yīng)用評(píng)價(jià) [J]. 中國(guó)內(nèi)鏡雜志, 2003; 9(7): 1-3.
  12. 12.  Tibble JA, Cairns SR. Role of endoscopic endoprostheses in proximal malignant biliary obstruction [J]. J Hepatobiliary Pancreat Surg, 2001; 8(2): 118-123.
  13. 13.  Ferlitsch A, Oesterreicher C, Dumonceau JM, et al. Diamond stents for palliation of malignant bile duct obstruction: a prospective multicenter evaluation [J]. Endoscopy, 2001; 33(8): 645-650.
  14. 14.  薛平, 胡以則, 盧海武, 等. ERCP在肝細(xì)胞癌并膽管癌栓時(shí)的應(yīng)用 [J]. 中華消化內(nèi)鏡雜志, 2004; 21(2): 107-109.
  15. 15.  Blechacz B, Gores GJ. Cholangiocarcinoma: advances in pa-thogenesis, diagnosis, and treatment [J]. Hepatology, 2008; 48(1): 308-321.
  16. 16.  孫凱, 孫權(quán), 劉志蘇. ERCP對(duì)壺腹周?chē)┑脑缙谠\斷價(jià)值 [J]. 臨床外科雜志, 2003; 11(5): 297-298..
  17. 17.  林琪. ERCP對(duì)膽總管下段及周?chē)膊〉脑\斷價(jià)值 [J]. 中國(guó)內(nèi)鏡雜志, 2003; 9(7): 55-57..
  18. 18.  李春生, 張照輝, 張能維, 等.十二指腸乳頭旁憩室伴縮窄性乳頭炎24例臨床分析 [J]. 中華普通外科雜志, 2001; 16(9): 534-535..
  19. 19.  Ascunce G, Ribeiro A, Rocha-Lima C, et al. Single-session endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography for evaluation of pancreaticobiliary disorders [J]. Surg Endosc, 2010; 24(6): 1447-1450.
  20. 20.  Tanaka K, Kida M. Role of endoscopy in screening of early pancreatic cancer and bile duct cancer [J]. Dig Endosc, 2009; 21 Suppl 1: S97-S100.
  21. 21.  Cotton P, Williams C. Practical gastrointestinal endoscope  [M]. 4th ed. Oxford: Blackwell Science, 1996: 139-183.
  22. 22.  Judah JR, Draganov PV. Endoscopic therapy of benign biliary strictures [J]. World J Gastroenterol, 2007; 13(26): 3531-3539.
  23. 23.  Costamagna G, Pandolfi M, Mutignani M, et al. Long-term results of endoscopic management of postoperative bile duct strictures with increasing numbers of stents [J]. Gastrointest Endosc, 2001; 54(2): 162-168.
  24. 24.  Catalano MF, Linder JD, George S, et al. Treatment of symptomatic distal common bile duct stenosis secondary to chronic pancreatitis: comparison of single vs. multiple simultaneous stents [J]. Gastrointest Endosc, 2004; 60(6): 945-952.
  25. 25.  Cantù P, Hookey LC, Morales A, et al. The treatment of patients with symptomatic common bile duct stenosis secondary to chronic pancreatitis using partially covered metal stents: a pilot study [J]. Endoscopy, 2005; 37(8): 735-739..
  26. 26.  Kahaleh M, Behm B, Clarke BW, et al. Temporary placement of covered self-expandable metal stents in benign biliary strictures: a new paradigm? (with video) [J]. Gastrointest Endosc, 2008; 67(3): 446-454..
  27. 27.  Vitale GC, Tran TC, Davis BR, et al. Endoscopic management of postcholecystectomy bile duct strictures [J]. J Am Coll Surg, 2008; 206(5): 918-923.
  28. 28.  陳訓(xùn)如.普通外科微創(chuàng)技術(shù)應(yīng)用現(xiàn)狀及展望 [J].中國(guó)普外基礎(chǔ)與臨床雜志, 2005; 12(6): 533-536.
  29. 29.  Davids PH, Tanka AK, Rauwas EA, et al. Benign biliary strictures. Surgery or endoscopy? [J]. Ann Surg, 1993; 217(3): 237-243.
  30. 30.  〖JP3〗廖娟, 李榮坤, 王春暉, 等. 肝移植術(shù)后膽道并發(fā)癥的內(nèi)鏡治療 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2010; 17(4): 333-337.
  31. 31.  〖JP3〗鞠衛(wèi)強(qiáng), 何小順, 邰強(qiáng), 等. ERCP治療肝移植術(shù)后膽道并發(fā)癥的療效評(píng)價(jià) [J]. 中華消化內(nèi)鏡雜志, 2009; 26(6): 295-298.
  32. 32.  Folkers MT, Disario JA, Adler DG. Long-term complications of endoscopic biliary sphincterotomy for choledocholithiasis: a North-American perspective [J]. Am J Gastroenterol, 2009; 104(11): 2868-2869.
  33. 33.  Sugiyama M, Atomi Y. Risk factors predictive of late complications after endoscopic sphincterotomy for bile duct stones: long-term (more than 10 years) follow-up study [J]. Am J Gastroenterol, 2002; 97(11): 2763-2767.
  34. 34.  Kageoka M, Watanabe F, Maruyama Y, et al. Long-term prognosis of patients after endoscopic sphincterotomy for choledocholithiasis [J]. Dig Endosc, 2009; 21(3): 170-175.
  35. 35.  朱化剛. 有關(guān)ERCP在膽胰疾病診治中應(yīng)用的思考 [J]. 肝膽外科雜志, 2006; 14(6): 413-415.