在手术改变解剖学的内镜胆道排水
Marco Spadaccini1,2, Carmelo Marco Giacchetto1, Matteo Fiacca1
1Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital-IRCCS, Via Manzoni 56, Rozzano, 20089 Milan, Italy.
Diagnostics (Basel, Switzerland)
|December 22, 2023
概括
透视逆行胆血管细胞造影 (ERCP) 面临着手术改变解剖学的挑战. 新的内镜超声波 (EUS) 技术为胆管排水提供了先进的解决方案,改善了复杂病例的结果.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 胆汁干预 胆汁干预
背景情况:
- 内镜逆行胆血管细胞造影 (ERCP) 是胆道阻塞的标准,但在手术改变的解剖学 (SAA) 方面很困难.
- 由于减肥手术和胰腺癌干预措施,SAA越来越普遍.
- 传统的替代方案,如皮肤透过肝胆道排水 (PTBD) 或手术都有局限性.
研究的目的:
- 审查SAA患者胆管排水的不断发展的内镜技术.
- 突出新肠镜和内镜超声波 (EUS) 方法的作用.
- 讨论在ERCP中克服解剖学挑战的进展.
主要方法:
- 审查创新的内镜方法,包括顶部辅助前内镜和肠镜.
- 详细检查各种EUS指导的胆道通道和排水技术.
- 讨论特定的基于EUS的方法,如约会,前级,超壁,以及EUS指导的跨胃ERCP (EDGE).
主要成果:
- 虽然新的内镜方法能够在SAA中实现ERCP,但它们可能是复杂和耗时的.
- 基于EUS的技术,包括约会,前级和超级方法,显示出显著的前景.
- EUS指导的跨胃ERCP (EDGE) 程序是胃绕道术后患者的显著进展.
结论:
- 不断发展的内镜技术,特别是EUS指导的干预措施,正在扩大复杂解剖学中的胆汁排水的选择.
- 这些进展旨在提高内镜胆道干预的成功率和可访问性.
- 在EUS和肠镜的进一步发展为未来的创新在管理胆道阻塞的潜力.
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