[The use of endoscopic method in treatment of strictures of biliary tree].
The strictures of bilitary tree may occur as a result of benign and malignant pathologies of liver and pancreas. The benign stricture of biliary tree are usually results of the surgery and if it is possible the endoscopic methods should be implemented in this group of patients. In case of the stricture of biliary tree in the course of the chronic pancreatitis a surgery should be chosen, because the widening and endoscopic stenting don't allow the long term removal of stricture. In course of cholangitis sclerosans endoscopic treatment is to ensure bile flow. The treatment of malignant stricture of biliary tree depends on the early diagnosis, placement and the extension of malignant lesion. Among the patients who are qualified to radical treatment, the surgical treatment should be applied. Palliative surgical treatment is usually used in laparotomy, when the non-removable tumor was diagnosed. In case of disqualification of the patient from surgical treatment in palliative treatment of malignant stricture of biliary tree, the method of choice is the endoscopic treatment and in case of failure from the pericotaneous drainage should be applied. The palliative endoscopic treatment usually is based on widening the stricture and putting into bilitary tree the plastic stent or more effective selfplacing metal ones, which are usually more effective, The achievement of long lasting medical effects after application of endoscopic methods relies on the cause leading to extrahepatic cholestasis and the extension of common bile structure. In most cases they do have character of urgent or palliative treatment. The study shows some of the treatment methods and the combination of different techniques, which may be used in case of bile flow obstruction because of the stricture of biliary tree. The final choice of treatment method is based on the clinical condition of a patient and the availability of the method and experience at using it.
Wojskowy Instytut Medyczny w Warszawie, Klinika Gastroenterologii CSK MON. stanislaw61@poczta.onet.pl
Stanisław
S
Wojtuń
Jerzy
J
Gil
Bogusław
B
Zyśko
D001649:Bile Duct Diseases / Q000175:diagnosis / Q000628:therapy; D001650:Bile Duct Neoplasms / Q000175:diagnosis / Q000628:therapy; D001662:Biliary Tract Surgical Procedures; D002404:Catheterization; D002760:Cholangiopancreatography, Endoscopic Retrograde; D015209:Cholangitis, Sclerosing / Q000175:diagnosis / Q000628:therapy; D001651:Cholestasis, Extrahepatic / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D002780:Cholestasis, Intrahepatic / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D003251:Constriction, Pathologic / Q000209:etiology / Q000628:therapy; D006801:Humans; D010166:Palliative Care; D011183:Postoperative Complications; D016717:Sphincterotomy, Endoscopic; D015607:Stents