胆总管下段癌的腔内超声与ERCP诊断价值比较

目的比较内镜超声(EUS)、胆管腔内超声(IDUS)与内镜下逆行胰胆管造影(ERCP)对胆总管下段癌的诊断价值.方法回顾分析上海长海医院1999年8月至2003年8月期间,同期施行EUS、IDUS和ERCP检查,并经手术标本病理证实的42例胆总管下段癌患者的病例资料,比较EUS、IDUS和ERCP的诊断价值.结果 42例患者中,男24例,女18例,平均年龄53.9岁.EUS检出39例(92.9%),IDUS检出42例(100%),ERCP检出40例(95.2%),三者检出率差异无统计学意义(P>0.05).EUS漏检的3例病灶均局限于胆管壁,但被IDUS确诊.结论 EUS与ERCP对胆总管下段癌具有相当的检出率, EUS和ERCP联合IDUS可提高早期胆总管下段癌的诊断水平.

Endosonography and endoscopic retragrade cholangiopancreatography diagnosis for lower part of common bile duct cancer

Objective To compare the diagnostic value of endoscopic ultrasonography (EUS), intraductal ultrasonography (IDUS) and endoscopic retragrade cholangiopancreatography (ERCP) for lower part of common bile duct cancer. Methods Forty two patients who were all pathologically confirmed lower part of common bile duct cancer, including 24 males and 18 females, with a mean age of 53.9 years, underwent EUS, IDUS and ERCP examinations before operation. The data of these patients were analyzed, and the positive rate of each method was compared. Results Thirty nine cases were found by EUS (92.9%), forty two cases by IDUS (100%), and forty cases by ERCP (95.2%). There was no significant difference between the three methods ( P >0.05). Among the three cases who were not found by EUS, the lesions were limited in the wall of common bile duct and were found by IDUS. Conclusion EUS is a sensitive method to diagnose common bile duct cancer. Combined with IDUS, EUS or ERCP can improve the diagnostic level of cancer located in the lower part of common bile duct.