肝外胆管恶性狭窄的鉴别诊断

孟春艳; 王菁; 王波

doi:10.12449/JCH240433

肝外胆管恶性狭窄的鉴别诊断

DOI: 10.12449/JCH240433

孟春艳^a,
王菁^b,
王波^a, , ,

a.
华中科技大学同济医学院附属同济医院消化内科，武汉 430030
b.
华中科技大学同济医学院附属同济医院健康管理中心，武汉 430030

基金项目:

湖北省基金面上项目 (2021CFB401);

湖北省卫生健康委面上项目 (WJ2023M014)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：孟春艳负责数据收集，论文撰写；王菁负责文献查询，研究指导；王波负责论文撰写及修改。

详细信息

通信作者:
王波， wangbo@tjh.tjmu.edu.cn （ORCID： 0000-0002-3238-266X）

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出版历程
- 收稿日期: 2023-07-09
- 录用日期: 2023-08-14
- 出版日期: 2024-04-25

Advances in the differential diagnosis of malignant bile duct stenosis

Chunyan MENG^a,
Jing WANG^b,
Bo WANG^{a
, ,
,}

a.
Department of Gastroenterology, Tongji Hospital，Tongji Medical College of Huazhong University of Science and Technology，Wuhan 430030，China
b.
Health Management Center，Tongji Hospital，Tongji Medical College of Huazhong University of Science and Technology，Wuhan 430030，China

Research funding:

Hubei Provincial Natural Science Foundation of China (2021CFB401);

Hubei Province Health and Family Planning Scientific Research Project (WJ2023M014)

More Information

Corresponding author: WANG Bo， wangbo@tjh.tjmu.edu.cn （ORCID： 0000-0002-3238-266X）

摘要

摘要: 引起肝外胆管狭窄的病因很多，其中良性狭窄可以通过药物治疗及内镜干预获得较好的疗效。恶性狭窄如能早期诊断，并及时行手术治疗有望延长患者的生存期。然而，肝外胆管恶性狭窄的鉴别诊断迄今为止仍然较为困难。本文就血清学、影像学、内镜相关技术及人工智能技术在肝外胆管恶性狭窄鉴别诊断中的进展进行综述，以期为制订临床诊疗方案提供策略和参考。
- 胆管，肝外 /
- 胰胆管造影术，内窥镜逆行 /
- 人工智能 /
- 诊断，鉴别
Abstract: There are various etiologies for extrahepatic bile duct stenosis， and pharmacotherapy and endoscopic intervention can achieve a good clinical effect in benign stenosis. Early diagnosis and timely surgical treatment of malignant stenosis may prolong the survival time of patients. However， there are still difficulties in the differential diagnosis of malignant bile duct stenosis. This article reviews the application of serology， radiology， endoscopic techniques， and artificial intelligence in the differential diagnosis of malignant bile duct stenosis， so as to provide strategies and references for formulating clinical diagnosis and treatment regimens.
- Bile Ducts， Extrahepatic /
- Cholangiopancreatography， Endoscopic Retrograde /
- Artificial Intelligence /
- Diagnosis， Differential

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图 1 肝外胆管恶性狭窄的IDUS表现

Figure 1. Intraductal ultrasonography findings of malignant extrahepatic bile duct stenosis

下载: 全尺寸图片幻灯片

图 2 肝外胆管恶性狭窄的EUS表现

Figure 2. Endoscopic ultrasound imaging of malignant extrahepatic bile duct stenosis

下载: 全尺寸图片幻灯片

图 3 肝外胆管恶性狭窄的POCS表现

Figure 3. Peroral cholangioscopy images of malignant extrahepatic bile duct stenosis

下载: 全尺寸图片幻灯片

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