胆道癌ERCP诊断(附49例分析)

本文报道用ERCP诊断胆管癌24例、胆囊癌6例、壶腹癌19例、共49例,都经手术或病理证实,诊断符合率为85.7％。 文章描述了胆道癌ERCP的X线表现。依造影所见把胆管癌分为阻塞型、狭窄型和息肉型。狭窄型又分闭塞型、环型及弥漫型三个亚型。胆管癌以阻塞型和闭塞型狭窄多见。胆囊癌表现为胆囊内基底宽广固定不变的充盈缺损。壶腹癌为壶腹部边缘不整的占位病变,可阻塞胆管或胰管或同时阻塞胰胆管。肝内胆管的软藤状改变是胆道恶性肿瘤的特征性表现。

DIAGNOSIS OF CARCINOMA OF BILIARY TRACT BY ERCP: AN ANALYSIS OF 49 CASES

Twenty-four cases of carcinoma of biliary duct, 6 of carcinoma of gallbladder and 19 of carcinoma of Vater's ampulla are reported. All of those 49 cases were con- firmed by operation and/or pathology.The diagnostic accuracy by endoscopic retragra-de cholangiopancreatography(ERCP)was 85.7%.The radiological appearances of carcinoma of biliary tract under ERCP were described and classified into 3 types, namely obstruction,stricture and polypoid types. The stricture type was further divided into 3 subtypes of occlusive,annular and diffuse stenosis.The obstruction type and occlusive stenosis type were more common. Carcinoma of gallbladder manifested as a constant filling defect with a wide base in the gallbladder, while carcinoma of ampulla as an irregularly bordered space occupying lesion in it, which could obstruct the biliary duct and/or pancreatic duct. The soft rattan-form change in intrahepatic biliary ducts was the characteristic manifestation of malignant tumor of biliary tract.