Эндоскопические методы диагностики и лечения проксимальной билиарной обтурации опухолевого генеза (обзор литературы)

Проксимальная билиарная обтурация происходит при опухоли Клацкина, внутрипеченочной холангиокарциноме, раке желчного пузыря или метастатическом поражении ворот печени и сопровождается плохим прогнозом. Совершенствование эндоскопических технологий осуществляют в направлении более точной диагностики и более безопасного дренирования. Транспапиллярную щеточную и щипцовую биопсию широко применяют для морфологической диагностики. Развиваются такие методы диагностики, как пероральная холангиоскопия и конфокальная лазерная эндомикроскопия. Разработка различных инструментов и прогресс в таких технологиях, как ЭРХПГ и эндо-УЗИ, позволили увеличить частоту технически и клинически успешных процедур при высоком билиарном блоке. Тем не менее обсуждение параметров стентов, места локорегионарной паллиативной терапии и некоторых других аспектов все еще продолжается. В обзоре литературы представлены сведения об оптимальных эндоскопических методах диагностики и лечения, применяемых при проксимальной злокачественной билиарной обтурации, полученные в результате анализа последних научных публикаций.

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