在Roux-en-Y胃绕道手术后,以肠镜辅助的EUS指导的跨胃干预
Madeline Seagle1, Wencheng Li2, James Perumpillichira3
1Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA.
Obesity surgery
|November 13, 2023
概括
通过内镜超声波导向的跨胃干预 (EDGI) 能够治疗具有Roux-en-Y解剖的患者. 灯膜安装金属支架 (LAMS) 促进了胆固醇病和恶性瘤的诊断和管理.
科学领域:
- 胃肠病学 胃肠病学
- 干预性内镜检查是干预性的内镜检查.
- 手术瘤学手术瘤学
背景情况:
- 在Roux-en-Y胃绕道 (RYGB) 解剖学中,对内镜干预提出了独特的挑战.
- 使用光膜附着金属支架 (LAMS) 进行内镜超声波导向的跨胃干预 (EDGI) 是管理RYGB患者并发症的新兴技术.
研究的目的:
- 描述一种新的方法来管理RYGB解剖的患者的胆固醇和恶性瘤.
- 证明LAMS在为随后的内逆向胆血管细胞造影 (ERCP) 和细针吸收 (FNA) 创建跨胃通道时的实用性.
主要方法:
- 一名患有RYGB解剖学,呈现胆固醇质症和逆腺淋巴病的患者接受了肠镜检查,以排除胃部位.
- 进行了光膜安装金属支架 (LAMS) 放置,以建立一个胃瘤.
- 通过LAMS进行的治疗ERCP促进了胆道结石的去除,EUS-FNA通过LAMS诊断出准大动脉淋巴结的恶性病变.
主要成果:
- 成功安装LAMS允许进行两阶段内镜干预.
- 胆道结石被移除,恶性瘤通过EUS-FNA得到证实.
- 两周后,LAMS被移除,缺陷被关闭,随后的上部GI系列显示没有泄漏.
结论:
- 与LAMS一起的EDGI是RYGB患者复杂干预的可行和有效策略.
- 这种方法可以在这个具有挑战性的患者群体中促进胆道和瘤疾病的诊断和治疗.
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