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| 1 | 光学相干断层扫描辨别肝门部胆管癌肿瘤前沿临床应用研究显示文摘目的探索光学相干断层扫描(OCT)技术辨别肝门部胆管癌肿瘤前沿位置的可行性。方法回顾性分析北京清华长庚医院收治的2例术前分别诊断为BismuthⅣ型和Ⅲb型肝门部胆管癌,接受围肝门+左三肝叶切除手术。两枚标本离体后均沿胆管轴向剖开胆总管-肝总管、右前肝管、左肝管。利用OCT设备扫描此三支管道,判断癌与正常胆管交界部位,并进行缝线标记,送病理学检查。结果病理学检查确诊2例均为肝门部胆管癌。OCT扫描可见正常胆管壁表现为低反射的黏膜上皮、高反射的黏膜下结缔-肌层及外层低反射的结缔层。肿瘤区域表现为管壁分层结构消失,多发无反射团块,可伴有乳头状凸起。2枚标本共6处标记,OCT判断肿瘤前沿与病理学检查位置相差<1 mm共4处,相差2 mm共1处,相差7 mm共1处。结论 OCT技术作为快速实时成像方式具有判断肝门部胆管癌肿瘤前沿的应用潜力。 | 汤睿 范应威 贾凡 李昂 肖颖 李莉 康宏向 樊海宁 董家鸿 卢倩 | 2019 | 中国实用外科杂志2019，39，9： | 2 |
| 2 | Biliary endoscopy in the management of primary sclerosing cholangitis and its complications显示文摘Primary sclerosing cholangitis(PSC)is a chronic,idiopathic,cholestatic liver disease characterized by inflammation and fibrosis of the intrahepatic and/or extrahepatic bile ducts.It can affect individuals of all age groups and gender,has no established pharmacotherapy,and is associated with a variety of neoplastic(e.g.cholangiocarcinoma)and non-neoplastic(e.g.dominant strictures)hepatobiliary complications.Given these considerations,endoscopy plays a major role in the care of patients with PSC.In this review,we discuss and provide updates regarding endoscopic considerations in the management of hepatobiliary manifestations and complications of PSC.Where evidence is limited,we suggest pragmatic approaches based on currently available data and expert opinion. | Brian M.Fung James H.Tabibian | 2019 | Liver Research2019，3，2： | 2 |
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