Холангиоскопия в диагностике и лечении злокачественных новообразований желчных протоков

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Вопросы диагностики и лечения злокачественных новообразований желчных протоков до сих пор остаются предметом дискуссий онкологов, хирургов, эндоскопистов и морфологов. Использование уточняющих методов диагностики, способствующих не только оценке распространенности онкологического процесса, но и получению достаточного объема материала для морфологического подтверждения диагноза, является краеугольным камнем в лечении этой группы пациентов. Неоднократное выполнение эндоскопической ретроградной холангиографии в комбинации с биопсией под рентгенологическим контролем зачастую не дает нужного результата, а оценка распространенности образования по желчным протокам на основании данных только современных методов лучевой диагностики приводит к R1-резекциям в 10—21% случаев. Данная обзорная статья посвящена истории развития и современным взглядам на внутрипротоковую эндоскопию в диагностике и лечении злокачественных новообразований желчных протоков. Особое внимание уделено разработкам эндоскопической семиотики, оценке распространенности опухолевого процесса и особенностям малоинвазивных оперативных вмешательств с применением холангиоскопии.

Ключевые слова:

холангиоскопия

холангиокарцинома

эндоскопическая семиотика

опухоль Клацкина

диагностика новообразований желчных протоков

транспапиллярная биопсия

Авторы:

Водолеев А.С.

Московский научно-исследовательский онкологический институт им. П.А. Герцена — филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава России

ORCID: 0000-0002-5151-7718

Гончар Е.В.

ORCID: 0009-0003-9379-1808

Дата поступления:

30.04.2023

Дата принятия в печать:

22.05.2023

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