经皮肝穿刺胆道造影术下的胆道活组织检查诊断阻塞性黄疸

目的：探索PTC胆道活检的可行性和敏感性，指导临床治疗。方法：26例阻塞性黄疸，在行PTCD(经皮肝穿刺胆道内外引流术)减黄术中，进行PTC胆道活检。此技术通过经皮经肝穿刺通道送入8F鞘，将活检钳经鞘内送入并对病变狭窄段行胆道活检，获取多个标本，然后行组织病理学检查。结果：26例中有24例获得组织病理学诊断(敏感性92．31％)。病理报告为胆管腺癌15例，胆管鳞癌1例，胰腺癌2例，肝癌2例，胃腺癌胆总管转移1例，硬化性胆管炎1例，胆管慢性炎症1例，胆管结石1例，阴性结果2例，阳性结果率为92．31％。结论：PTC下胆道活检是一种简单易行、准确可靠的获取组织学病理检查途径。

Percutaneous transhepatic cholangiobiopsy in diagnosis of obstructive jaundice

ObjectiveTo explore the technical feasibi lity an d sensitivity of percutaneous transhepatic cholangiobiopsy in malignant obstruct ive jaundice,and guide the clinical treatment.Methods26 patients with malignant obstructive jaundice who were treated by percutaneous transhepatic cholangiograph and drainage were accepted percutaneous transhepatic cholangiobiopsy,the technique was performed through an existing percutaneous transhepatic tract,multiple specimens were obtained afte r passing the forceps biopsy through a long 8-french sheath and the specimens we re fixed with formalin,and then for histopathologic diagnosis.Results The histopathologic diagnosis was acquired in 24 of 26 pati ents(sensitivity,92.31%).Pathologic reports included 15 cholangioadenocarcinomas , 1 cholangiosquamocarcinoma, 2 pancreatic adenocarcinomas hepatoma with common bile duct invasion, 1 stomachoadenocarcinoma with common bile duct metastasis, 1 biliary chronic inflammation, 1 biliary stone. ConclusionPercutaneous transhepatic cholangiobiopsy is an accurate and reliable way which is safe and easy to perform to acquire histopat hologic diagnosis.