经皮经肝胆道内钳夹活检诊断胆道支架内再梗阻
Percutaneous Transhepatic Biliary Clamp Biopsy in the Diagnosis of Biliary Stent Reobstruction
许凯豪 1宋梦瑶 1周学良 1孙占国 1方毅 1韩新巍 1焦德超1
作者信息
- 1. 450052 郑州大学第一附属医院放射介入科
- 折叠
摘要
目的 评估经皮经肝胆道钳夹活检诊断胆道支架再梗阻的有效性.方法 31例胆道支架植入术后发生支架内再梗阻[男19例,女12例,年龄47～83岁,平均(61.5±11.3)岁]接受透视引导下经皮经肝胆道钳夹活检术.评估技术成功率、并发症、手术时间及平均活检次数,分析敏感度、特异度、准确度、阳性预测率及阴性预测率.结果 技术成功率100％,平均手术时间(23.0±6.3)min,平均活检次数(3.9±0.6)次,并发症发生率为9.7％(3/31),包括胆道出血2例,胆管炎1例,未出现大出血、胆道穿孔等严重并发症.23例被确诊为恶性肿瘤,3例诊断为真阴性,5例诊断为假阴性,无假阳性诊断.胆道钳夹活检对支架再梗阻的诊断性能:敏感度79.3％(23/29),特异度为100％(3/3),准确度为83.9％(26/31),阳性预测率为100％(23/23),阴性预测率为37.5％(3/8).结论 透视下经皮经肝胆道钳夹活检诊断胆道支架再梗阻技术安全可行.
Abstract
Objective To evaluate the effectiveness of percutaneous transhepatic biliary clamp biopsy in the diagnosis of biliary stent re-obstruction.Methods From December 2015 to December 2019,31 patients with stent re-obstruction af-ter biliary stent implantation[19 males and 12 females,aged 47-83 years,mean age(61.5±11.3)years]underwent percutaneous transhepatic biliary clamp biopsy under fluoroscopy guidance.The technical success rate,complications,oper-ation time and average number of biopsies were evaluated,and the sensitivity,specificity,accuracy,positive predictive rate and negative predictive rate were analyzed.Results The technical success rate was 100％,the average operation time was(23.0±6.3)min,the average number of biopsies was 3.9±0.6,and the incidence of complications was 9.7％,including 2 cases of biliary bleeding and 1 case of cholangitis.There were no serious complications such as massive hemorrhage and bile duct perforation.Twenty-three cases were correctly diagnosed as malignant tumors,three were diagnosed as true-nega-tive,five were diagnosed as false-negative,and there were no false-positive diagnoses.The diagnostic performance of biliary clamp biopsy for stent re-obstruction:the sensitivity was 79.3％(23/29),the specificity was 100％(3/3),the accuracy was 83.9％(26/31),the positive predictive rate was 100％(23/23),and the negative predictive rate was 37.5％(3/8).Conclusion Percutaneous transhepatic biliary clamp biopsy under fluoroscopy is safe and feasible in the diagnosis of bili-ary stent re-obstruction.
关键词
胆管梗阻/胆管支架/梗阻/钳夹活检Key words
Bile duct obstruction/Bile duct stent/Obstruction/Clamp biopsy引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据