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本文报告94例恶性梗阻性黄疸PTC诊断的初步体会。除胆管梗阻形态和有无胆管移位外,强调了决定受累胆管水平在鉴别不同恶性梗阻病因上的重要性,并提出一个把肝外胆管梗阻分为四段的简单方法。我们发现,梗阻在肝门段和胰腺上段以胆管癌最常见,其次为胆囊癌或转移癌侵犯胆管;梗阻在胰腺段者常为胰腺癌;若梗阻在壶腹段,壶腹癌是最可能的诊断。因此,认为这些分析原则,有助于不伺恶性梗助病变的鉴别诊断,并能获得更高的正确诊断率。本组病例正确诊断率达93.6％。
This article reports the preliminary experience of PTC diagnosis of 94 cases of malignant obstructive jaundice. In addition to the appearance of bile duct obstruction and the presence or absence of bile duct displacement, the importance of determining the level of affected bile ducts in differentiating the causes of different malignant obstructions was emphasized, and a simple method to divide the extrahepatic bile duct obstruction into four segments was proposed. We found that obstruction was most common in the hilar segment and the upper segment of the pancreas, followed by gallbladder cancer or metastatic carcinoma. The obstruction in the pancreas was often pancreatic cancer; if the obstruction was in the ampulla, ampulla was most likely. Diagnosis. Therefore, these analytical principles are considered to be helpful in not differentially diagnosing malignant lesions and obtaining a higher correct diagnosis rate. The correct rate of diagnosis in this group was 93.6%.