胆管息肉与胆管壁肿瘤的胆道镜下微波切除
Microwave ablation for the treatment of bile duct polyp and papilloma under choledochoscope
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.
更多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.
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