PTCD: Percutaneous Transhepatic Cholangio-Drainage PTBD:Percutaneous transheptic biliary drainage 经皮经肝胆道引流 PTGBD: Percutaneous transhepatic gallbladder drainage 经皮经肝胆囊引流...
右侧还是左侧,或两侧?用最少的胆管或支撑架充分引流最大的肝容积 ERCP 或 PTCD 支撑架或导管引流 塑料支撑架或金属支撑架 覆膜支撑架还是裸支撑架 在壶腹部以上引流还是超越壶腹部...
Metal Stenting Principles Self-expanding stents Wallstent (Boston Scientific) Long stents (prevent overgrowth) 6-8 mm for lobar or segmental ducts 8-12 mm for CHD Long overlap between telescoping stents Prevents separation after shortening...
NCCN 2016 guidelines favored metal stent placement for pancreas adenocarcinoma * NCCN 2017 guideline favor plastic stent (consider metal stent) * NCCN 2017 guidelines for hepatobiliary cancers recommend biliary drainage...
经皮定位穿刺是指经皮穿刺胆道前在皮肤标记进针穿刺点 经皮超声引导下引流 经皮CT引导下引流 经皮透视引导下引流...
根据 Clinical History; Physical exam 和 Laboratory tests,可以诊断大约90%的梗阻性黄疸。影像学的主要任务是: 1. 确定诊断 2. 决定梗阻的水平 3. 查明病因 4. 制定治疗计划 传统诊断梗阻性黄疸主要依赖PTC,经皮胆道造影;随着影像学的进步,PTC is dea...
穿刺点选择(三级以上最大引流胆管穿刺-两步法) 经皮肝内穿刺盲穿胆道 选择某一支三级胆道 向左旋转管球,针尖与胆道离开,说明针尖在胆道前方,如果针与胆道交叉,说明针在胆道的后方。每重叠一次针尖与胆道,就旋转一次管球,会发现针尖与胆道离开或交叉的...
Causes of biliary occlusion (BO) 胆管结石 Choledocholithiasis 胰胆肿瘤 Biliopancreatic neoplasias Head of the pancreas Cholangiocarcinoma Ampullary tumor Metastases in the hepatic hilum 良性狭窄 Benign stenosis Chronic pancreatitis Inflamm...
58岁男性 四段肝癌, 左半肝切除术,肝胆管空肠吻合术 术后第七天,肝下引流管持续大量胆汁流出,怀疑胆肠吻合口漏,胆红素正常...
适应症 外科术前 姑息治疗 ERCP vs PTCD vs 联合治疗 优缺点 姑息治疗...
15天之后...