PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAPHY IN THE DIAGNOSTICS OF COMMON BILE DUCT DISEASES COMPLICATED BY OBSTRUCTIVE JAUNDICE*

V. Boyko, Y. Avdosyev, A. Sochnieva, D. Yevtushenko, D. V. Minukhin
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Abstract

Aim: Evaluation of the effectiveness of percutaneous transhepatic cholangiography in the diagnostics of bile duct diseases complicated by obstructive jaundice. Material and methods: This article presents the experience of using percutaneous transhepatic cholangiography in 88 patients with benign and malignant common bile duct diseases complicated by obstructive jaundice. Results: Methods of direct contrasting of the biliary tract make it possible to visualize choledocholithiasis with 86.5% accuracy, with 84.1% common bile duct strictures, with 87.8% stricture of biliodigestive anastomosis and with 97.5% accuracy of cholangiocarcinomas. Conclusions: Direct antegrade bile duct enhancement should be used if ERCPG has low explanatory value. PTCG in case of “endoscopically complicated forms” of choledocholithiasis, CBD and BDA strictures and cholangiocarcinomas enhances all bile duct sections and helps assess the level and completeness of biliary blockade. Following PTCG, measures can be taken to achieve biliary decompression regardless of OJ genesis.
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经皮经肝胆管造影对胆总管疾病合并梗阻性黄疸的诊断价值
目的:评价经皮肝胆管造影对胆管疾病合并梗阻性黄疸的诊断价值。材料与方法:本文介绍了88例良、恶性胆总管病变合并梗阻性黄疸患者经皮经肝胆管造影的经验。结果:胆道直接造影法对胆总管结石的显像准确率为86.5%,对胆总管狭窄的显像准确率为84.1%,对胆管吻合口狭窄的显像准确率为87.8%,对胆管癌的显像准确率为97.5%。结论:当ERCPG解释价值较低时,应采用直接顺行胆管增强。对于“内镜下复杂形式”的胆总管结石、CBD和BDA狭窄以及胆管癌,PTCG可增强所有胆管切片,有助于评估胆道阻塞的程度和完全性。在PTCG后,无论OJ发生与否,都可以采取措施实现胆道减压。
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