臨牀透析 Vol.23 No.1(2-7)


特集名 透析患者におけるInterventional radiology
題名 [各論]胆道系疾患とIVR
発刊年月 2007年 01月
著者 武内 周平 旭川厚生病院放射線科
著者 齋藤 博哉 旭川厚生病院放射線科
著者 鉾立 博文 旭川厚生病院放射線科
著者 湯浅 憲章 旭川厚生病院放射線科
著者 竹井 俊樹 旭川厚生病院放射線科
著者 高邑 明夫 旭川厚生病院放射線科
【 要旨 】 胆管癌は治癒切除後の予後は比較的良好だが,切除率は必ずしも高いとはいえない.高齢や重篤な合併症のため手術適応外となる症例も多い.とくに,腎機能低下例では積極的な抗腫瘍療法が行えないことも多い.抗腫瘍療法を行わない症例に対しては,メタリックステントによる内瘻術が選択される.その場合,通常のbare stentでは,留置後早期に腫瘍による再閉塞が懸念されるため,covered stentが用いられている.
Theme Interventional Radiology for Dialysis Patients
Title Criteria for and technical aspects of IVR therapy for dialysis patients
Author Shuhei Takeuchi Department of Radiology, Asahikawa Kosei General Hospital
Author Hiroya Saito Department of Radiology, Asahikawa Kosei General Hospital
Author Hirofumi Hokodate Department of Radiology, Asahikawa Kosei General Hospital
Author Noriaki Yuasa Department of Radiology, Asahikawa Kosei General Hospital
Author Toshiki Takei Department of Radiology, Asahikawa Kosei General Hospital
Author Akio Takamura Department of Radiology, Asahikawa Kosei General Hospital
[ Summary ] In relation to other biliary tract cancers, the prognosis for bile duct cancer is relatively good after curative resection. However, the resection rate cannot necessarily be said to be high. Moreover, many cases fall outside the indicafions for surgery because of advanced age or serious complications. The use of metallic stent offers good palliation of malignant billiary obstructions. Metallic stent is indicated in patients with minor tumors in their bile ducts. In the case of inefficient therapy, covered metallic stent should be chosen for long term patency, associated with extended survival.
The indications for metallic stent as well as techniques for stenting, in regard to bile duct stenosis are described.
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