不确定的胆道狭窄的临床方法:临床表现,诊断和检查
Sujani Yadlapati1, Ramzi Mulki2, Sergio A Sánchez-Luna2
1Department of Gastroenterology and Hepatology, Indiana University Hospital, Indianapolis, IN 46202, USA. syadlapati@iuhealth.org.
World journal of gastroenterology
|October 30, 2023
概括
诊断不确定的胆道狭窄症 (IDBS) 是一个挑战. 本综述概述了诊断策略和基于证据的算法,用于管理这些复杂的病例,改善患者的治疗结果.
科学领域:
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
- 诊断成像 诊断成像 诊断成像
背景情况:
- 胆管狭窄带来了诊断挑战,需要早期的良性或恶性决定.
- 胆道狭窄的延迟诊断会增加死亡率和发病率.
- 不确定的胆道狭窄 (IDBSs) 缺乏确定的成像或组织病理学诊断.
研究的目的:
- 审查IDBS的病因,临床表现和诊断/管理策略.
- 为IDBS管理提供基于证据的诊断算法.
- 为突出IDBS诊断的先进内镜技术.
主要方法:
- 审查关于IDBS诊断和管理的当前文献.
- 讨论常规的内镜逆行胆血管细胞造影 (ERCP) 技术,包括刷细胞学和活检.
- 探索先进的内镜方式,如内镜超声波 (EUS) 引导的程序,胆管镜和共聚焦激光内显微镜.
主要成果:
- IDBS通常需要采用多模式诊断方法.
- 传统的组织采样方法 (ERCP,刷细胞学,活检) 是关键.
- 先进的内镜技术为IDBS提供了更好的诊断产量.
结论:
- 基于证据的算法集成各种诊断工具对于管理IDBS至关重要.
- 准确的IDBS诊断对于适当的患者管理和改善结果至关重要.
- 对先进的内镜技术的进一步研究可以提高IDBS诊断.
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