CAJ | 학술논문

目的研究探讨胆道镜下微波切除与治疗胆管息肉与胆管壁肿瘤的价值与方法.方法选择收治的胆管息肉及息肉样变54例,胆管壁乳头状瘤6例及1例胆管癌栓患者,治疗方法:①经胆道镜活检病变组织;②经胆道镜操作孔导入同轴天线;③反复插入病变实质内后接通电源,至整个病变汽化或炭化、缩小直至消失;④如遇到细蒂息肉,可利用胆道镜切除,然后用取石网套取;⑤定期复查,必要时可追加上述治疗.结果 ①胆管息肉及息肉样病变、胆管壁良性肿瘤60例,经术中术后胆道镜微波治疗后,所有上述胆管壁病变均消失或基本消失,1例胆管下端多发乳头状瘤,手术后复发;②1例术中胆道镜探查见右肝管开口处瘤栓,经术中胆道镜直视下微波烧灼,随访72个月无复发;③本组所有患者术后无明显出血、穿孔等并发症.结论胆管息肉与胆管壁肿瘤经胆道镜联合微波技术治疗,安全性高、疗效确切.
목적 연구탐토담도경하미파절제여치료담관식육여담관벽종류적개치여방법.방법 선택수치적담관식육급식육양변54례,담관벽유두상류6례급1례담관암전환자,치료방법:①경담도경활검병변조직;②경담도경조작공도입동축천선;③반복삽입병변실질내후접통전원,지정개병변기화혹탄화、축소직지소실;④여우도세체식육,가이용담도경절제,연후용취석망투취;⑤정기복사,필요시가추가상술치료.결과 ①담관식육급식육양병변、담관벽량성종류60례,경술중술후담도경미파치료후,소유상술담관벽병변균소실혹기본소실,1례담관하단다발유두상류,수술후복발;②1례술중담도경탐사견우간관개구처류전,경술중담도경직시하미파소작,수방72개월무복발;③본조소유환자술후무명현출혈、천공등병발증.결론 담관식육여담관벽종류경담도경연합미파기술치료,안전성고、료효학절.
Objective To evaluate microwave resection and ablation for the treatment of bile duct polyp and bile duct papilloma under choledochoscope.Methods This study included 54 cases of bile duct polyp,6 cases of bile duct papilloma and one bile duct obstruction by sloughed hepatic carcinoma.After biopsy through choledochoscope coaxial antenna was led-in and lesion were evaluated or carbonized by microwave.Pedicled polyps were cut by choledochoscope and removed by stone net.Results All the bile duct benign lesions disappeared or almost disappeared.One case of multiple papilloma recurred and ablation was repeated.Cancer thrombus in right hepatic duct in one case was removed and stump microwave ablated.After 72 months of follow-up,there was no obstruction recurrence.There was no bleeding,perforation and other major complications postoperatively.Conclusions Choledochoscopy combined with microwave technique for the treatment of bile duct polyps and bile duct tumors is safe and effective.