临床内镜超声波导向胆囊排水在重症监护病房的危急病患者
Raj Jessica Thomas1, Arjun Chatterjee2, Mohamed Abdallah2
1Department of Internal Medicine, Cleveland Clinic Akron General, Akron, OH, USA.
Scandinavian journal of gastroenterology
|December 2, 2024
概括
床边内镜超声波导向胆囊排水 (EUS-GBD) 为患有急性胆囊炎的重症患者提供了一种安全和可行的选择. 这种方法为高风险个体提供了初步改善,当其他方法不适合时.
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.
- 关键护理医学 关键护理医学
背景情况:
- 胆囊切除术是中等风险患者急性胆囊炎的标准.
- 穿皮透肝胆囊排水 (PT-GBD) 和内式超声波引导胆囊排水 (EUS-GBD) 是高危人群的替代方案.
- PT-GBD有禁忌,重症患者可能无法转移到这些手术中.
研究的目的:
- 评估临床EUS-GBD在重症监护室的可行性和安全性.
- 评估EUS-GBD作为不适合PT-GBD或转移的患者的替代方案.
主要方法:
- 一个涉及三名危急病患者的病例系列,他们在ICU的床边接受了EUS-GBD.
- 专注于技术可行性,安全性和患者最初的结果.
主要成果:
- 床边EUS-GBD在技术上是可行的,并且在所有三个重症病患的ICU患者中都是安全的.
- 所有患者都观察到手术后的初始改善.
- 尽管最初的排水成功,但由于严重的潜在疾病,所有患者最终都需要舒适的护理.
结论:
- 床边EUS-GBD是一种可行且安全的胆囊排水选择,用于其他干预措施是不可能的危急病重症监护病房患者.
- 多学科团队的支持对于成功实施至关重要.
- 需要进一步的研究来证实EUS-GBD在管理高风险重症监护病房患者中的扩大作用.
相关概念视频
Endoscopic Procedures V: ERCP
136
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...
136
Endoscopic Studies II: Thoracocentesis
223
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
223
Endoscopic Procedures I: Esophagogastroduodenoscopy
79
An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
During an EGD, the endoscope can be used to:
79
Esophageal Varices-II: Clinical Features and Management
57
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
57
Endoscopic Procedures III: Video Capsule Endoscopy
97
Capsule endoscopy, or wireless or video capsule endoscopy, is a diagnostic procedure for examining the entire gastrointestinal tract. Patients swallow a capsule about the size of a vitamin tablet. The capsule is equipped with a transmitter, a battery, an LED light source, and a color video camera to capture images throughout the gastrointestinal tract. This procedure is particularly useful for diagnosing conditions such as Crohn's disease, ulcerative colitis, tumors, polyps, ulcers,...
97
Appendicitis-II: Diagnostic Studies and Management
72
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
72

