恶性梗阻性黄疸的内镜诊治进展

Endoscopic diagnosis and treatment of malignant obstructive jaundice

恶性梗阻性黄疸是由各种恶性肿瘤引起的胆道梗阻性疾病，因就诊时多为疾病晚期，故现内镜下治疗已逐渐替代手术治疗。内镜下诊断方法有内镜逆行胰胆管造影、超声内镜、子母胆道镜等。恶性梗阻性黄疸的内镜下治疗目前以置入胆道支架较多见，另有超声内镜下胆一肠造瘘术、内镜射频消融术、内镜近距离放疗、内镜光动力治疗等，磁珠压迫技术为近几年发展起来的一项新技术，其疗效还有待观察。随着科学技术的不断发展，无论是内镜技术还是耗材工艺方面，都有着不断的进步，将来内镜诊疗一定会有更加广阔的应用前景。

Malignant obstructive jaundice is biliary obstruction caused by malignant tumors. When a patient presents to a doctor, he/she is usually too late to be operated, so endoscopic treatment has gradually replaced surgery in its management. Diagnostic endoscopic methods include endoscopic retrograde cholangiopancreatography （ERCP）, endoscopic ultrasonography （EUS）, and per oral cholangios-copy （POCS）, etc. Biliary stent placement at ERCP is the mainstay of endoscopic palliation for jaundice. Other methods include EUS-guided bilioenteric drainage （EGBD）, endoscopic radiofrequency ablation, intraluminal brachytherapy of bile duct, endoscopic photodynamic therapy, etc. Magnetic Compression Anastomosis Technique （MCAT） is a new technology which has been developed recently, and its role in the management of malignant obstructive jaundice remains to be seen. Science and technology have brought along progress in endoscopic and consumable technologies. It is predicted that in the ,future, endoscopic diagnosis and treatment will have more applications.