Diagnosis of biliary tract and ampullary carcinomas
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- 作者：Kazuhiro Tsukada (1)
Tadahiro Takada (2)
Masaru Miyazaki (3)
Shuichi Miyakawa (4)
Masato Nagino (5)
Satoshi Kondo (6)
Junji Furuse (7)
Hiroya Saito (8)
Toshio Tsuyuguchi (9)
Fumio Kimura (3)
Hideyuki Yoshitomi (3)
Satoshi Nozawa (3)
Masahiro Yoshida (2)
Keita Wada (2)
Hodaka Amano (2)
Fumihiko Miura (2) - 关键词：Biliary tract neoplasm ; Endoscopic ultrasonography (EUS) ; Multidetector computed tomography (MDCT) ; Guidelines
- 刊名：Journal of Hepato-Biliary-Pancreatic Sciences
- 出版年：2008
- 出版时间：January 2008
- 年：2008
- 卷：15
- 期：1
- 页码：31-40
- 全文大小：651KB
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Tadahiro Takada (2)
Masaru Miyazaki (3)
Shuichi Miyakawa (4)
Masato Nagino (5)
Satoshi Kondo (6)
Junji Furuse (7)
Hiroya Saito (8)
Toshio Tsuyuguchi (9)
Fumio Kimura (3)
Hideyuki Yoshitomi (3)
Satoshi Nozawa (3)
Masahiro Yoshida (2)
Keita Wada (2)
Hodaka Amano (2)
Fumihiko Miura (2)
1. Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Science for Research, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
2. Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
3. Department of General Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
4. Department of Gastroenterological Surgery, Fujita Health University, Toyoake, Japan
5. Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
6. Department of Surgical Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
7. Hepatobiliary and Pancreatic Oncology Division, National Cancer Center Hospital East, Chiba, Japan
8. Department of Radiology, Asahikawa Kosei General Hospital, Asahikawa, Japan
9. Department of Medicine and Clinical Oncology, Chiba University Graduate School of Medicine, Chiba, Japan
文摘
Diagnostic methods for biliary tract carcinoma and the efficacy of these methods are discussed. Neither definite methods for early diagnosis nor specific markers are available in this disease. When this disease is suspected on the basis of clinical symptoms and risk factors, hemato-biochemical examination and abdominal ultrasonography are performed and, where appropriate, enhanced computed tomography (CT) and/or magnetic resonance cholangiopancreatography (MRCP) is carried out. Diagnoses of extrahepatic bile duct cancer and ampullary carcinoma are often made based on the presence of obstructive jaundice. Although rare, abdominal pain and pyrexia, as well as abnormal findings of the hepatobiliary system detected by hemato-biochemical examination, serve as a clue to making a diagnosis of these diseases. On the other hand, the early diagnosis of gallbladder cancer is scarcely possible on the basis of clinical symptoms, so when this cancer is found with the onset of abdominal pain and jaundice, it is already advanced at the time of detection, thus making a cure difficult. When gallbladder cancer is suspected, enhanced CT is carried out. Multidetector computed tomography (MDCT), in particular -one of the methods of enhanced CT -is useful for decision of surgical criteria, because MDCT shows findings such as localization and extension of the tumor, and the presence or absence of remote metastasis. Procedures such as magnetic resonance imaging, endoscopic ultrasonography, bile duct biopsy, and cholangioscopy should be carried out taking into account indications for these procedures in individual patients. However, direct biliary tract imaging is necessary for making a precise diagnosis of the horizontal extension of bile duct cancer.