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- 저자 : ( Valeriy Vladimirovich Boyko ) (검색결과 1 건)
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( Valeriy Vladimirovich Boyko ),( Yuriy Vladimirovich Avdosyev ),( Anastasiia Lvovna Sochnieva ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: The aim of the study is evaluation of the efficacy of percutaneous transhepatic cholangiography (PTCG) in the diagnosis of the common bile duct diseases complicated by mechanical jaundice. Methods: In the period 2011-2017, 88 patients with the common bile duct diseases were hospitalized: “endoscopically complex forms” of choledocholithiasis - 6 (6,8%), strictures of the common bile duct - 2 (2,3%), strictures of biliodigestive anastomosis - 7 (8%) and cholangiocarcinomas - 73 (82.9%) of different localization according to the Bismuth-Corlette classification. PTCG were performed on the angiograph “Integris Allura 12” (“Philips”, The Netherlands). Results: PTCG was performed in 82 (93.1%) patients. Re PTCG made 20 (22.7%) patients. The diameters of segmental and lobular hepatic ducts ranged from 4 to 12 mm and from 6 to 14 mm, respectively (on average 7.8 mm and 9.6 mm, respectively), and the common bile duct - from 8 to 21 mm (average 13.8 mm). Contrasting with only one part of the liver was noted in 11 (13.4%) patients. The nature and level of obstruction set in 80 (97.5%). The proximal biliary block was detected in 59 (71.9%) patients, distal in 23 (28%). Partial passage of contrast agent in the duodenum was observed in 59 (71.9%) patients, complete occlusion - 23 (28%). Partial passage of contrast medium through the stricture zone was detected in 8 (9.75%) patients. Full biliary block detected in 15 (18.3%) patients, partial - in 67 (81.7%). The sensitivity, specificity and accuracy of PTCG for the common bile duct diseases were calculated: for choledocholithiasis - 80%, 98.5%, 86.5%; for strictures of the common bile duct - 66,6%, 95,7%, 84,1%; for strictures of biliodigestive anastomosis - 71,4%, 95,7%, 87,8%; for cholangiocarcinomas - 98.5%, 92.8%, 97.5% respectively. The wrong diagnosis was made in 2 (2.5%) patients. False-positive conclusions made in 8 (9.8%) and false-negative in 5 (6.1%). Conclusions: PTCG in diseases of the common bile duct complicated by mechanical jaundice in 97.5% of cases makes it possible to contrast all parts of the bile ducts, as well as to assess the level and completeness of the biliary block.
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