切换至 "中华医学电子期刊资源库"

中华普通外科学文献(电子版) ›› 2017, Vol. 11 ›› Issue (01) : 56 -60. doi: 10.3877/cma.j.issn.1674-0793.2017.01.015

所属专题: 文献

综述

内镜治疗恶性胆道梗阻的应用现状
李越1, 何南1, 曹良启1,()   
  1. 1. 510260 广州医科大学附属第二医院肝胆外科
  • 收稿日期:2016-07-02 出版日期:2017-02-01
  • 通信作者: 曹良启
  • 基金资助:
    广东省科技计划项目(2014A020212326); 广东省自然基金资助项目(2015A030313466)

Research progress of endoscopic treatment for malignant biliary obstruction

Yue Li1, Nan He1, Liangqi Cao1,()   

  1. 1. Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
  • Received:2016-07-02 Published:2017-02-01
  • Corresponding author: Liangqi Cao
  • About author:
    Corresponding author: Cao Liangqi, Email:
引用本文:

李越, 何南, 曹良启. 内镜治疗恶性胆道梗阻的应用现状[J]. 中华普通外科学文献(电子版), 2017, 11(01): 56-60.

Yue Li, Nan He, Liangqi Cao. Research progress of endoscopic treatment for malignant biliary obstruction[J]. Chinese Archives of General Surgery(Electronic Edition), 2017, 11(01): 56-60.

恶性胆道梗阻是由胆道或其他转移性恶性肿瘤所致的胆道梗阻性疾病,主要以梗阻性黄疸、胆管扩张、肝损伤为其临床表现,后期患者肝功能恶化,容易合并急性梗阻性化脓性胆管炎及肾衰竭等病症,大部分患者就医时已为晚期,失去手术机会。经内镜逆行胰胆管造影(ERCP)内镜下放置鼻胆管引流、支架以及胆道腔内射频消融、内镜下光动力治疗等作为姑息性微创治疗手段,已在临床上广泛开展,而且与经皮肝穿刺胆管引流术(PTCD)相比,ERCP具有患者痛苦少、操作相对简单等优点。本文整理相关文献,综述经ERCP内镜下解除恶性胆道梗阻的主要方法及其研究现状。

Malignant biliary obstruction is caused by biliary or other metastatic malignant tumors, mainly with obstruction jaundice, bile duct dilatation, and liver damage as its clinical presentation. In later period, patients are characterized with deterioration of liver function, easily combined with acute obstructive and suppurative cholangitis and kidney function exhaustion. Most of the patients are late for medical treatment and lose the chance of operation. The endoscopic retrograde cholangiopancreatography(ERCP), a palliative minimally invasive treatment, has endoscopic nasobiliary drainage and stents, intraductal radiofrequency, endoscopic photodynamic therapy, and been carried out widely. Compared with percutaneous transhepatic catheter drainage (PTCD), ERCP has advantages of less pain and simpler operation. In this paper, the main methods and research progress of ERCP in relieving malignant biliary obstruction are reviewed.

[1]
Boulay BR,Birg A. Malignant biliary obstruction: From palliation to treatment[J]. World J Gastrointest Oncol, 2016, 8(6): 498-508.
[2]
Inamdar S,Slattery E,Bhalla R, et al. Comparison of adverse events for endoscopic vs percutaneous biliary drainage in the treatment of malignant biliary tract obstruction in an Inpatient National Cohort[J]. JAMA Oncol, 2016, 2(1): 112-117.
[3]
Kumar R,Sharma BC,Singh J, et al. Endoscopic biliary drainage for severe acute cholangitis in biliary obstruction as a result of malignant and benign diseases[J]. J Gastroenterol Hepatol, 2004, 19(9): 994-997.
[4]
Sasahira N,Hamada T,Togawa O, et al. Multicenter study of endoscopic preoperative biliary drainage for malignant distal biliary obstruction[J]. World J Gastroenterol, 2016, 22(14): 3793-3802.
[5]
Hu B,Zhou D,Gong B. The evaluation of endoscopic biliary drainage for 288 patients with malignant hilar obstruction[J]. Zhonghua Wai Ke Za Zhi, 1997, 35(2): 73-76.
[6]
Sugiyama H,Tsuyuguchi T,Sakai Y et al. Preoperative drainage for distal biliary obstruction: endoscopic stenting or nasobiliary drainage[J]. Hepatogastroenterology, 2013, 60(122): 231-234.
[7]
Rustagi T,Jamidar PA. Intraductal radiofrequency ablation for management of malignant biliary obstruction[J]. Dig Dis Sci, 2014, 59(11): 2635-2641.
[8]
Alis H,Sengoz C,Gonenc M, et al. Endobiliary radiofrequency ablation for malignant biliary obstruction[J]. Hepatobiliary Pancreat Dis Int, 2013, 12(4): 423-427.
[9]
Zoepf T,Jakobs R,Arnold JC, et al. Palliation of nonresectable bile duct cancer: improved survival after photodynamic therapy[J]. Am J Gastroenterol, 2005, 100(11): 2426-2430.
[10]
Dolak W,Schreiber F,Schwaighofer H, et al. Endoscopic radiofrequency ablation for malignant biliary obstruction: a nationwide retrospective study of 84 consecutive applications[J]. Surg Endosc, 2014, 28(3): 854-860.
[11]
Sharaiha RZ,Sethi A,Weaver KR, et al. Impact of radiofrequency ablation on malignant biliary strictures: results of a collaborative registry[J]. Dig Dis Sci, 2015, 60(7): 2164-2169.
[12]
Mensah ET,Martin J,Topazian M. Radiofrequency ablation for biliary malignancies[J]. Curr Opin Gastroenterol, 2016, 32(3): 238-243.
[13]
Wilcox CM,Kim H,Seay T, et al. Choice of plastic or metal stent for patients with jaundice with pancreaticobiliary malignancy using simple clinical tools: a prospective evaluation[J]. BMJ Open Gastro, 2015, 2(1): e000014.
[14]
Elwir S,Sharzehi K,Veith J, et al. Biliary stenting in patients with malignant biliary obstruction: comparison of double layer, plastic and metal stents[J]. Dig Dis Sci, 2013, 58(7): 2088-2092.
[15]
Lübbert C,Wendt K,Feisthammel J, et al. Epidemiology and resistance patterns of bacterial and Fungal colonization of biliary plastic stents: a prospective cohort study[J]. Published, 2016, 11(5): e0155479.
[16]
Hamada T,Isayama H,Nakai Y, et al. Tips and troubleshooting for transpapillary metal stenting for distal malignant biliary obstruction[J]. J Hepatobiliary Pancreat Sci, 2014, 21(3): E12-18.
[17]
Naitoh I,Nakazawa T,Ban T, et al. 8-mm versus 10-mm diameter self-expandable metallic stent in bilateral endoscopic stent-in-stent deployment for malignant hilar biliary obstruction[J]. J Hepatobiliary Pancreat Sci, 2015, 22(5): 396-401.
[18]
Yamamoto R,Takahashi M,Osafune Y, et al. Comparison of endoscopic stenting for malignant biliary obstruction: a single-center study[J]. World J Gastrointest Endosc, 2015, 7(9): 889-894.
[19]
Darcózi T,Bor R,Fábián A, et al. Cost-effectiveness trial of self-expandable metal stents and plastic biliary stents in malignant biliary obstruction[J]. Orvosi Hetilap, 2016, 157(7): 268-274.
[20]
Chung KH,Lee SH,Park JM, et al. Self-expandable metallic stents vs. plastic stents for endoscopic biliary drainage in hepatocellular carcinoma[J]. Endoscopy, 2015, 47(6): 508-516.
[21]
Zorrón Pu L,de Moura EG,Bernardo WM, et al. Endoscopic stenting for inoperable malignant biliary obstruction: A systematic review and meta-analysis[J]. World J Gastroenterol, 2015, 21(47): 13374-13385.
[22]
Hong W,Sun X,Zhu Q. Endoscopic stenting for malignant hilar biliary obstruction: should it be metal or plastic and unilateral or bilateral[J]. Eur J Gastroenterol Hepatol, 2013, 25(9): 1105-1112.
[23]
Hong WD,Chen XW,Wu WZ, et al. Metal versus plastic stents for malignant biliary obstruction: an update meta-analysis[J]. Clin Res Hepatol Gastroenterol, 2013, 37(5): 496-500.
[24]
Lee BS,Ryu JK,Jang DK, et al. Reintervention for occluded metal stent in malignant bile duct obstruction: a prospective randomized trial comparing covered and uncovered metal stent[J]. J Gastroenterol Hepatol, 2016, 5,31.
[25]
Barkun AN,Adam V,Martel M, et al. Partially covered self-expandable metal stents versus polyethylene stents for malignant biliary obstruction: a cost-effectiveness analysis[J]. Can J Gastroenterol Hepatol, 2015, 29(7): 377-383.
[26]
Kahaleh M,Talreja JP,Loren DE, et al. Evaluation of a fully covered self-expanding metal stent with flared ends in malignant biliary obstruction: a multicenter study[J]. J Clin Gastroenterol, 2013, 47(10): 96-100.
[27]
Lee JH,Krishna SG,Singh A, et al. Comparison of the utility of covered metal stents versus uncovered metal stents in the management of malignant biliaray strictures in 749 patients[J]. Gastrointest Endosc, 2013, 78(2): 312-324.
[28]
Park JS,Jeong S,Lee DH, et al. A double-layered covered biliary metal stent for the management of unresectable malignant biliary obstruction: A multicenter feasibility study[J]. Gut Liver, 2016, 5,16.
[29]
Shatzel J,Kim J,Sampath K. Drug eluting biliary stents to decrease stent failure rates: A review of the literature[J]. World J Gastrointest Endosc, 2016, 8(2): 77-85.
[30]
Jang SI,Kim JH,You JW. Efficacy of a metallic stent covered with a paclitaxel-incorporated membrane versus a covered metal stent for malignant biliary obstruction: a prospective comparative study[J]. Dig Dis Sci, 2013, 58(3): 865-871.
[31]
Suk KT,Kim JW,Kim HS. Human application of a metallic stent covered with a paclitaxel-incorporated membrane for malignant biliary obstruction: multicenter pilot study[J]. Gastrointest Endosc, 2007, 66(4): 798-803.
[32]
Bertani H,Frazzoni M,Mangiafico S, et al. Cholangiocarcinoma and malignant bile duct obstruction: A review of last decades advances in therapeutic endoscopy[J]. World J Gastrointest Endosc, 2015, 7(6): 582-592.
[33]
Choi JM,Kim JH,Kim SS, et al. A comparative study on the efficacy of covered metal stent and plastic stent in unresectable malignant biliary obstruction[J]. Clin Endosc, 2012, 45(1): 78-83.
[34]
Singh V. Decompression of malignant biliary obstruction after failed ERCP: to EUSBD and not to PTBD[J]. Dig Dis Sci, 2015, 60(2): 288-289.
[35]
Fabbri C,Luigiano C,Fuccio L, et al. EUS-guided biliary drainage with placement of a new partially covered biliary stent for palliation of malignant biliary obstruction: a case series[J]. Endoscopy, 2011, 43(5): 438-441.
[36]
Nguyen-Tang T,Binmoeller KF,Sanchez-Yague A, et al. Endoscopic ultrasound (EUS)-guided transhepatic anterograde self-expandable metal stent (SEMS) placement across malignant biliary obstruction[J]. Endoscopy, 2010, 42(3): 232-236.
[37]
Hucl T. Malignant biliary obstruction[J]. Cas Lek Cesk, 2016, 155(1): 30-37.
[38]
Beer F,Wiedmann M,Tannapfel A, et al. Photodynamic therapy for advanced bile duct cancer: evidence for improved palliation and extended survival[J]. Hepatology, 2000, 31(2): 291-298.
[39]
Pereira SP,Ayaru L,Rogowska A, et al. Photodynamic therapy of malignant biliary strictures using meso-tetrahydroxyphenylchlorin[J]. Eur J Gastroenterol Hepatol, 2007, 19(6): 479-485.
[40]
Matull WR,Dhar DK,Ayaru L, et al. R0 but not R1/R2 resection is associated with better survival than palliative photodynamic therapy in biliary tract cancer[J]. Liver Int, 2011, 31(1): 99-107.
[41]
刘俊杰,薛平. 晚期胆管癌姑息性切除、光动力治疗及支架引流疗效的Meta分析[J/CD]. 中华普通外科学文献(电子版), 2015, 9(3): 242-248.
[42]
Ortner ME,Caca K,Berr F, et al. Successful photodynamic therapy for nonresectable cholangiocarcinoma: a randomized prospective study[J]. Gastroenterology, 2003, 125(5): 1355-1363.
[1] 范晓翔, 章美武, 吕淑懿, 庄鲁辉, 张燕. 经胆管超声造影在超声引导下经皮肝穿刺胆道引流中的价值[J]. 中华医学超声杂志(电子版), 2023, 20(03): 332-336.
[2] 熊峰, 杨宏锋, 颜骏, 王纯, 金兆辰. ICU患者胆汁淤积症相关危险因素分析及其对预后的影响[J]. 中华危重症医学杂志(电子版), 2022, 15(01): 42-46.
[3] 王大燕, 李小兵, 赖盼建. citrin缺陷所致新生儿肝内胆汁淤积症的SLC25A13基因IVS16ins3kb突变类型分析[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(03): 315-322.
[4] 张玉凤, 徐鹏飞, 唐甜甜, 刘瑞清, 万涵. 儿童川崎病并发胆汁淤积和无菌性脑膜炎一例[J]. 中华实验和临床感染病杂志(电子版), 2023, 17(01): 60-64.
[5] 蔡茗, 俞亚红. 胆总管结石术后复发危险因素的研究进展[J]. 中华普通外科学文献(电子版), 2022, 16(06): 438-442.
[6] 宋奇锋, 高良辉, 林师佈, 李永强, 曾维乾. 三种不同预切法在ERCP困难插管中的临床效果分析[J]. 中华普外科手术学杂志(电子版), 2022, 16(05): 526-529.
[7] 朱俊杰, 王斌, 刘覃, 蔡志杰. LC联合LCBDE对急性结石性胆囊炎合并胆总管结石的临床疗效[J]. 中华普外科手术学杂志(电子版), 2022, 16(04): 458-461.
[8] 赵建廷, 吕春光, 李江, 吴琼. 胆道支架植入联合胆道外引流治疗恶性胆道梗阻的近中期随访评价[J]. 中华普外科手术学杂志(电子版), 2022, 16(04): 454-457.
[9] 范清泉, 宋晓玲, 翁明哲, 顾钧. 消化道重建术后ERCP安全性和疗效分析[J]. 中华肝脏外科手术学电子杂志, 2023, 12(03): 331-335.
[10] 郭世龙, 杨潇, 胡欢欢, 杨梁, 周文富, 丛魁武, 张雨胜, 李英锋. ERCP在胆胰疾病微创治疗中的有效性及安全性[J]. 中华肝脏外科手术学电子杂志, 2023, 12(02): 216-220.
[11] 郝杰, 李宇, 陈晨, 杨雪, 陶杰, 王铮, 董鼎辉, 仵正, 孙昊. 十二指肠侧视镜引导下ERCP在消化道重建术后胆胰疾病治疗中的应用[J]. 中华肝脏外科手术学电子杂志, 2023, 12(02): 221-226.
[12] 肖慜, 顾杨军, 林鑫, 庄莉, 李启勇. T管支撑与内镜综合治疗肝移植术后胆管坏死合并胆管结石一例[J]. 中华肝脏外科手术学电子杂志, 2022, 11(02): 206-208.
[13] 郭志唐, 白锦峰, 孙敏, 滕毅山, 李世思, 陈章彬. PTCD与ERCP+ENBD在恶性梗阻性黄疸姑息性治疗中疗效比较[J]. 中华肝脏外科手术学电子杂志, 2021, 10(06): 564-569.
[14] 曹玲, 张业坡, 袁珊珊, 胡红杰, 余日胜. 恶性胆道梗阻行胆道支架置入术后危重并发症及其危险因素研究[J]. 中华消化病与影像杂志(电子版), 2023, 13(04): 203-210.
[15] 张盼盼, 高明生, 包楠迪, 石卉, 常青, 宫媛, 刘文徽, 李婷婷, 徐世平. 老年患者长期空肠管饲喂养后胆囊胆汁淤积的发生及风险预测研究[J]. 中华胃肠内镜电子杂志, 2023, 10(01): 20-26.
阅读次数
全文


摘要