| 经皮肝穿刺胆道内钳夹活检诊断恶性阻塞性黄疸胆肠吻合术后吻合口狭窄 |
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| 引用本文： | 李腾飞,李臻,韩新巍.经皮肝穿刺胆道内钳夹活检诊断恶性阻塞性黄疸胆肠吻合术后吻合口狭窄[J].临床放射学杂志,2011,30(1). |
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| 作者姓名： | 李腾飞 李臻 韩新巍 |
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| 作者单位： | 郑州大学第一附属医院放射介入科,450052 |
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| 摘 要： | 目的探讨经皮肝穿刺胆道造影(PTC)术中胆道钳夹活检诊断恶性阻塞性黄疸胆肠吻合术后吻合口狭窄的可行性和优越性,获取病变部位的组织病理学,指导临床治疗。资料与方法 PTC术中引入活检钳对18例恶性阻塞性黄疸胆肠吻合术后复发黄疸患者于梗阻部位活检,判断狭窄的良恶性,采取相应的减黄措施并观察其疗效。结果全部病例PTC造影显示梗阻部位均位于胆肠吻合口处,行钳夹活检,技术成功率100%,敏感性为94.4%(17/18),其中14例钳夹到肿瘤组织,证实为肿瘤复发;3例病理为纤维组织增生和(或)炎症,结合影像学及实验室检查,考虑瘢痕性狭窄;另1例钳夹阴性,但影像学、实验室检查及术后随访证实为肿瘤复发。所有患者钳夹术中均未出现消化道出血、穿孔等并发症。活检术后行内外引流管和(或)内支架置入,术后患者黄疸消退明显(P<0.05),精神状态及生活质量较术前均有不同程度改善。结论 (1)PTC术中胆道钳夹活检诊断胆管癌术后胆肠吻合口狭窄操作简单,安全,敏感性高;(2)采取介入方法降黄效果明显,操作简单,并发症少。
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| 关 键 词： | 经皮肝穿刺胆道造影术 恶性阻塞性黄疸 吻合口狭窄 胆管活检 |
Percutaneous Transhepatic Cholangiobiopsy in Pathological Diagnosis for Anastomotic Stenosis after Cholangiojejunostomy of Malignant Obstuctive Jaundice |
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| LI Tengfei,LI Zhen,HAN Xinwei.Percutaneous Transhepatic Cholangiobiopsy in Pathological Diagnosis for Anastomotic Stenosis after Cholangiojejunostomy of Malignant Obstuctive Jaundice[J].Journal of Clinical Radiology,2011,30(1). |
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| Authors: | LI Tengfei LI Zhen HAN Xinwei |
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| Institution: | LI Tengfei,LI Zhen,HAN XinweiDepartment of Radiology,the First Affiliated Hospital of Zhengzhou University,P.R.China |
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| Abstract: | Objective To explore the pathological diagnostic value and feasibility of percutaneous transhepatic cholangiobiopsy (PTCB) in anastomotic stenosis after cholangiojejunostomy of malignant obstuctive jaundice and guide the clinic to treat disease.Materials and Methods Eighteen patients with anastomotic stenosis after cholangiojejunostomy of malignant obstuctive jaundice performed percutaneous transhepatic cholangiobiopsy in the stenosis location and pathological diagnosis were achieved.Results All the patient... |
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| Keywords: | Percutaneous transhepatic cholangiography Malignant obstuctive jaundice Anastomotic stenosis Cholangiobiopsy |
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