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关于AMPULLAR瘤病变管理的最新情况

Roberta Maselli^1,2, Roberto de Sire^1,3, Alessandro Fugazza¹

¹Gastroenterology, Endoscopy Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy.

Diagnostics (Basel, Switzerland)

|October 14, 2023

概括

脉冲性瘤病变 (ANL) 是一种罕见的胃肠道癌症. 透视乳头切除术为特定的ANL提供了一种有效的治疗选择,扩展到良性病例之外.

科学领域:

胃肠道学和瘤学
胃肠道的恶性瘤
内視鏡外科手術內視鏡外科手術

背景情况:

囊性瘤病变 (ANL) 很少见,占肠道恶性瘤的0.6-0.8%和周围瘤的6-17% .
ANLs可以是零星的或与家族腺瘤多重症 (FAP) 等遗传综合征相关.
通常是无症状的,并且在食道胃管腺镜检查 (EGD) 期间偶然检测到,有症状的ANL可能伴有黄,疼痛,胰腺炎,胆管炎或 melaena.

研究的目的:

审查目前关于囊性瘤病变 (ANLs) 内镜诊断和治疗的证据.
要突出内镜乳头切除术 (EP) 在管理ANLs中不断变化的作用.
在ANL评估中讨论内镜,内镜超声波 (EUS) 和磁共振胆血管细胞造影 (MRCP) 的诊断能力.

主要方法:

审查关于内镜诊断和治疗ANLs的现有文献.
评估包括EGD,侧视十二指镜,EUS和MRCP在内的诊断方式.
对治疗方法的分析,重点是内镜乳头切除术 (EP).

主要成果:

像EGD,EUS和MRCP这样的诊断工具对于评估ANL大小,位置,特征,入侵深度和淋巴结参与至关重要.
内镜乳头切除术 (EP) 是对特定ANL的有效治疗方法,包括早期的膜癌.
对于EP的适应症已经从良性病变和非手术候选人扩大到包括复杂的病例,如巨大的横向扩散病变和导管内延伸.

结论:

内镜评估对于准确的ANL分期和治疗计划至关重要.
透视乳头切除术是一种可行且越来越多地用于治疗更广泛的囊性瘤病变的治疗选择.
进一步的研究和内镜技术的进步继续完善ANLs的管理.

关键词:

在 ERCP 中,ERCP 已成为 ERCP 的核心.囊性瘤性病变的发生.这种形瘤是型瘤.囊切除术 (ampullectomy) 是一个切除术.通过内镜进行乳头切除术 (endoscopic papillectomy).

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