| 摘要: |
| 恶性胆管梗阻（MBO）因胆汁排泄障碍引起梗阻性黄疸，可能导致胆管炎、脓毒血症、肝衰竭等并发症，甚至危及患者生命，胆管引流是解除症状、改善患者生活质量的有效手段。目前，对于无手术机会的MBO患者，经内镜逆行胰胆管造影（ERCP）置入金属支架是姑息性治疗的一线方法。近年来，对ERCP失败的MBO，超声内镜引导下胆管引流（EUS-BD）技术逐渐被接受，认为是优于经皮经肝穿刺胆管引流术（PTBD）的替代方法。有证据表明，由经验丰富的术者操作，对于远端MBO患者，EUS-BD甚至可以作为一线治疗方法替代ERCP。本文就EUS-BD在MBO中的研究进展进行综述。 |
| 关键词: 超声内镜 内镜逆行胰胆管造影术 胆管引流术 经皮经肝穿刺胆管引流术 恶性胆管梗阻 |
| DOI：10.16781/j.0258-879x.2020.08.0880 |
| 投稿时间：2019-09-01修订日期：2020-03-31 |
| 基金项目:无 |
|
| Endoscopic ultrasound-guided biliary drainage in malignant biliary obstruction: research progress |
| JIANG Qi1,ZHOU Wei1,ZOU Duo-wu2*,LI Zhao-shen1 |
(1. Department of Gastroenterology, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China;
2. Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
*Corresponding author) |
| Abstract: |
| Malignant biliary obstruction (MBO) leads to obstructive jaundice as a result of bile excretion disorder, which may cause complications such as cholangitis, sepsis, hepatic failure and even life-threatening. Biliary drainage is an effective mean to relieve symptoms and improve patients' quality of life. At present, endoscopic retrograde cholangiopancreatography (ERCP) is the first-line palliative treatment for MBO patients without surgical opportunity. In recent years, endoscopic ultrasound-guided biliary drainage (EUS-BD) has been gradually accepted as an alternative to percutaneous transhepatic biliary drainage (PTBD) in MBO with failed ERCP. The available evidence suggests that EUS-BD might even replace ERCP as the first-line procedure in patients with malignant distal biliary obstruction by experienced surgeons. This paper reviews the research progresses of EUS-BD in MBO. |
| Key words: endoscopic ultrasound endoscopic retrograde cholangiopancreatography biliary drainage percutaneous transhepatic biliary drainage malignant biliary obstruction |
