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胆道系统的内镜可访问性在术后的网站

Benedikt Aulinger¹, Kerstin Schütte^2,3, Christian Schulz^1,4

¹Medical Department II, University Hospital, LMU, Munich, Germany.

Visceral medicine

|November 16, 2023

概括

变化的上部胃肠道解剖学使胆道干预复杂化. 新型内镜技术在传统方法失败时提供解决方案,确保进入乳头或解.

科学领域:

胃肠病学胃肠病学
内镜手术进行内镜手术

背景情况:

上部胃肠道的解剖学变化对内镜干预提出了挑战,特别是对于胆道系统手术.
常规的内镜逆行胆血管细胞造影 (ERC) 可能在患有胃肠连续性改变的患者中无法到达乳头.
成功的内镜干预依赖于对个体术后解剖学的彻底了解.

研究的目的:

审查新的内镜技术,以访问有改变上部胃肠道解剖的患者的胆管树.
提供常见的替代方法的概述,当传统的ERC是不可行的.

主要方法:

对新型内镜技术的审查,包括内镜导向的方法,超管辅助方法和螺旋内镜.
讨论胆道接入的皮肤和混合方法.
分析到达乳头或 biliodigestive Anastomosis 的策略.

主要成果:

新的技术使胆管树可以进入尽管复杂的解剖学.
选择包括内声学,超导管辅助,螺旋肠镜和穿皮/混合方法.
这些方法有助于达到乳头或 biliodigestive anastomosis.

结论:

选择内镜方法必须根据临床因素,解剖学变化和患者特征进行个性化选择.
早期的跨学科合作对于确定最佳的风险/收益比率的最佳程序至关重要.
在复杂的胃肠道解剖学中,个性化治疗策略对于成功的内镜治疗至关重要.

关键词:

胆道排水胆道排水内镜逆行性胆血管细胞学图.用内镜超声波引导的胆道排水.通过皮肤进行的跨肝胆固醇排水.在Roux-en-Y的胃旁路术中.

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