跨胆囊十二指肠排水作为一种替代性去压方法,用于阿弗伦特循环综合征:两个病例报告
Journal of the Korean Society of Radiology
|June 14, 2024
概括
在胃切除术后的患者中,跨胆囊十二指管排水提供了一种新的非手术解压方法,用于 afferent loop 综合征 (ALS). 这种微创手术成功治疗了两名急性胰腺炎患者,避免了进一步的手术干预.
科学领域:
- 胃肠病学 胃肠病学
- 手术并发症 手术并发症
- 干预性放射学 干预性放射学
背景情况:
- 无情循环综合征 (ALS) 是胃切除术和胃肠道重建后的一种罕见但严重的并发症.
- ALS可能导致危及生命的疾病,包括胆管炎,胰腺炎和十二指肠穿孔.
- 紧急减压对于管理ALS和预防致命结果至关重要.
研究的目的:
- 报告跨胆囊十二指肠排水的成功应用,作为ALS的替代性减压方法.
- 为了呈现两个ALS病例在没有胆道扩张的情况下进行管理.
主要方法:
- 两名患有远距离胃切除术后表胃疼痛和吐的患者被诊断出患有ALS和急性胰腺炎.
- 穿囊十二指管排水是通过通过囊性管道放置导管来减压 afferent循环来进行的.
- 这种方法在没有胆道扩张的情况下被使用,这通常会阻止标准胆道接入.
主要成果:
- 在这两名患者中,通过穿囊疗法成功实现了对 afferent 循环的减压.
- 没有患者需要额外的外科手术来治疗ALS.
- 患者在良好的条件下出院,治疗后的恢复时间为2周和1个月.
结论:
- 跨胆囊十二指管排水是选择ALS患者紧急减压的可行和有效替代方案,特别是当胆道扩张不存在时.
- 这种微创的技术可以预防严重的并发症,并避免在患有胃切除术后 afferent loop 综合征的患者进一步手术.
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