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ADVANCED DIGESTIVE ENDOSCOPY: ERCP - PART 4

Nguyên nhân phổ biến nhất của tắc mật ác tính là ung thư tuyến tụy, tiếp theo là cholangiocarcinoma, ampullary khối u, và nén bên ngoài bằng cách hạch di căn trong hilum gan. Vai trò của ERCP trong khối u ác tính pancreaticobiliary là (1) xác định | CHAPTER 6 Advanced Digestive Endoscopy ERCP Edited by Peter B. Cotton Joseph Leung Copyright 2005 Blackwell Publishing Ltd The Role of ERCP in Pancreatico-Biliary Malignancies GULSHAN PARASHER AND JOHN G. LEE Synopsis Approximately 30 000 new cases of pancreatic cancer and 7000 biliary tract cancers are diagnosed annually in the United States 1 The most common euuneofsnul bd.ury ob nis ud arc a folded bycholangiocarcinoma ampullary neoplasm and extrinsic compression by metastaticlymphadenopathyin theliver hilum. Thh heUt C ERCPhopanecoatieh-hUlarymaiianendrs is lo llcdnfirmayed-agnosit oy obsmugideSaundimiu pitiirnrrwithsuTpeciedpanrreaCiccarcinymahcT-lhyeyaumoec 2 eletain times foc Uừ 3 satìhTlhe irdétTeoaiỉ 3ter ab0se lUs cyaeOehtct etcUsSi t ctid .i.e. omChtldreiUTna eatie dcUttuUucU hl decomprct eltenileducl andh5eTtlcit-faale dmiiaisceoharapyruch esindytumiamn esaci rtefscid- i r imiradhctal aTotoComieuiotherygy i TUìc chayhec dstcriCrc varíouecdtcenUaet emcrpidg aepUcotiaTtuemRCPiTtUemanngeme1ftoUpancreytieoebilierymatldhelecles. ERCP n diagnoch of daut e o i a mattguaTaies eadi ogkddiagnosis SignificanceoflCooble OuclsCricture sion The radiographic features of ERCP cannot reliably distinguish between benign gnd molignant dhogses. Although the double duct sign with simultaneous narrowing of the common bile duct and the pancreatic duct has been regarded OrsUltihilcliyatn edtctisdafpand catie cancer Fig. 6.1 recent studies showed that ttsepecipeityismothlawnr thinpeaviouslythobghtiWtthr5-37 ofauc patients having benign dieeate on long-term follow-up 2 3 . ttricture length 14mmwas highlg nrngictivo otmaiigo gnoylnonestubo 4 whiioinonotbee stsby thepancrertie du n tsrictnotlengopmnasuredon Lit on cgoeeiatenwitb bosh -sir co O.aoitoot St3gi4g p 0.0g0iod thr pagcreaticcancer g iTOn pgThis is trial version www.adultpdf. com -L THE ROLE OF ERCP IN PANCREATICO-BILIARY MALIGNANCIES 121 Fig. 6.1 A 76-year-old female was referred for evaluation of obstructive jaundice. .