内镜逆行胆血管与肌肉造影相关的穿孔的原因和管理:一项回顾性研究
Tetsuya Shimizu1, Masato Yoshioka1, Akira Matsushita1
1Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School.
概括
内镜逆行胆血管细胞造影 (ERCP) 穿孔是罕见但严重的. 早期诊断和及时管理,包括内镜或手术干预,对于成功的患者结果和避免死亡至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 内視鏡外科手術 內視鏡外科手術
- 胆腺疾病 胆腺疾病
背景情况:
- 透视逆行胆瘤造影 (ERCP) 是胆瘤疾病的重要诊断和治疗工具.
- 与ERCP相关的穿孔是一种可能致命的并发症,需要谨慎的管理决策.
研究的目的:
- 调查ERCP相关穿孔的原因.
- 确定ERCP相关穿孔的最佳管理策略.
主要方法:
- 在13年内对15个与ERCP相关的穿孔病例进行了回顾.
- 基于Stapfer分类的穿孔原因的分析.
- 对诊断方法和治疗结果的评估.
主要成果:
- 在7,896名ERCP中,穿孔发生在0.18%的患者中,大多数患者在手术期间被诊断出穿孔.
- 常见的原因包括范围诱导的损伤,杆切除术和仪器仪表.
- 管理范围从保守治疗和排水到手术不尽相同,没有报告死亡.
结论:
- 及时诊断和量身定制的治疗是有效管理ERCP相关穿孔的关键.
- 适当的干预措施可以导致成功的恢复,而不会导致死亡.
相关概念视频
01:28Esophageal Perforation-II: Clinical Manifestations and Management
98
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
98
01:26Endoscopic Procedures V: ERCP
450
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Patient...
450
01:22Esophageal Perforation-I: Introduction
134
Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
134
01:23Gastritis III: Clinical Manifestations and Management
343
The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
343
01:29Chronic Pancreatitis II: Collaborative Care
116
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
116