ERCP对肝外胆管癌的诊断价值

目的对手术病理证实的３１例肝外胆管癌进行回顾性分析．方法３１例患者均行胰胆管造影，并和Ｂ超及ＣＴ检查进行对照．结果上段胆管癌１６例，下段胆管癌１３例，中上段胆管癌２例．１例为横纹肌肉瘤，２例为腺瘤癌变，其余均为腺癌．ＥＲＣＰ成功２８例（９０３％），Ｂ超诊断符合率为８０７％，而ＣＴ显示梗阻８５０％，能明确病因者仅７００％．结论ＥＲＣＰ在早期诊断肝外胆管癌方面明显优于Ｂ超及ＣＴ检查，并能清晰地显示胆道系统的全貌，对治疗及手术方案选择有重要价值．

Diagnostic value of ERCP for extrahepatic biliary tract cancer

AIM To study the diagnostic value of ERCP in extrahepatic biliary tract cancer confirmed by pathological diagnosis. METHODS ERCP was performed on 31 patients with extrahepatic biliary tract cancer confirmed pathologically and compared with B ultrasonographic examination and CT scanning. RESULTS Upper segment biliary tract cancer, 16 cases, lower segment biliary cancer 13 and middle segment biliary tract cancer 1. One case was rhabdomyosarcoma; two cases canceration of adenoma and all of others were adenocarcinomas. ERCP was successful in 28 (90 3%) patients. The diagnostic accuracy with B ultrasonography was 80 7%, and biliary obstruction was demonstrated only in 85 0% of patients, and etiologic diagnosis can be made with CT only in 70 0% of these patients. CONCLUSION ERCP has more obvious advantages for early diagnosis of extrahepatic biliary tract cancer than B ultrasonic examination and CT scanning in treatment and selection of operative approaches.