CAJ | 학술논문

新兴的胆管腔内RFA治疗胆道恶性狭窄展现出良好的应用前景,但均是通过ERC或PTC途径置入射频导管,在X线监视下完成.2014年2月深圳市人民医院收治1例左肝内胆管腺癌侵犯肝总管并狭窄患者,入院前3个月行胆囊切除、胆总管切开取石和T管引流术,取胆管壁组织送快速冷冻切片病理学检查结果:反应性增生可能性大.术后患者恢复顺利.入院前1周患者全身皮肤、巩膜黄染,小便呈浓茶色,行经T管窦道胆道镜检查、肝总管狭窄扩张、活组织病理学检查和胆道外科支架置入术,病理学检查结果:胆管腺癌.因幽门粘连成角,无法行十二指肠镜放置胆道内支架管引流,经T管窦道在胆道镜直视下顺利施行了肝总管恶性狭窄胆管腔内RFA,定位准确,实时监控,保证了后期的重复治疗.
신흥적담관강내RFA치료담도악성협착전현출량호적응용전경,단균시통과ERC혹PTC도경치입사빈도관,재X선감시하완성.2014년2월심수시인민의원수치1례좌간내담관선암침범간총관병협착환자,입원전3개월행담낭절제、담총관절개취석화T관인류술,취담관벽조직송쾌속냉동절편병이학검사결과:반응성증생가능성대.술후환자회복순리.입원전1주환자전신피부、공막황염,소편정농다색,행경T관두도담도경검사、간총관협착확장、활조직병이학검사화담도외과지가치입술,병이학검사결과:담관선암.인유문점련성각,무법행십이지장경방치담도내지가관인류,경T관두도재담도경직시하순리시행료간총관악성협착담관강내RFA,정위준학,실시감공,보증료후기적중복치료.
Novel intraductal radiofrequency ablation for malignant biliary stricture indicated good therapeutic prospect.In traditional intraductal radiofrequency ablation,the radiofrequency catheter was placed through endoscopic retrograde cholangiography or percutaneous transhepatic cholangiogram under the supervision of X-ray.In February 2014,a patient with intrahepatic adenocarcinoma of the bile duct and malignant common hepatic duct stricture was admitted to the Shenzhen People's Hospital.The patient received cholecystectomy + choledocholithotomy + T tube drainage 3 months prior to the admission.The results of histopathological examination indicated reactive hyperplasia.The patient recovered uneventfully after the operation.One week before the admission,the patient had jaundice and umber urine and received choledochoscopy + common bile duct dilatation + histopathological examination + biliary stent placement.The results of pathological examination confirmed that the patient had intrahepatic adenocarcinoma of the bile duct.The patient received intraductal radiofrequency ablation through T-tube fistula under direct vision of choledochoscopy,and recovered well after the operation.Intraductal radiofrequency ablation under direct vision of choledochoscopy not only has the advantages of accurate positioning and real-time monitoring,but also facilitate cyclical repeat treatment.