在同时出现胃出口和胆道阻塞的情况下,EUS指导的透 ERCP
Vivek Kesar1, William F Abel1, Jay Bapaye1
1Division of Gastroenterology, Virginia Tech Carilion, Roanoke, Virginia.
Gastrointestinal endoscopy
|December 11, 2024
概括
在EUS指导的穿腺ERCP中,使用光体对立金属支架 (LAMS) 有效地治疗了衰弱患者的胃出口阻塞 (GOO) 和胆道阻塞,解决了黄并改善了GOO得分.
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.
- 胃肠道瘤学 胃肠道瘤学
背景情况:
- 同时出现的胃出口阻塞 (GOO) 和胆道阻塞会给管理带来挑战,特别是在严重衰弱的患者中.
- 对于GOO和胆道阻塞结合的患者,存在有限的治疗选择.
- 内镜逆行胆血管细胞造影 (ERCP) 经常受到GOO的阻碍.
研究的目的:
- 为了评估EUS引导的胃肠肠膜对立金属支架 (LAMS) 在GOO和胆道阻塞的患者中进行跨肠ERCP的安置的疗效和安全性.
- 建立一种新的方法来管理复杂的胆道和胃出口阻塞.
- 评估LAMS作为ERCP在不良外科候选人的道的实用性.
主要方法:
- 对九名GOO和胆道阻塞患者的回顾性分析.
- 部署一个20毫米x10毫米的LAMS来创建一个胃口口腔.
- 通过LAMS实现ERCP的执行,用于胆道接入和支架安置/交换.
主要成果:
- 在所有9名患者中成功安置了LAMS.
- 黄的百分之百解消通过跨阴茎ERCP实现.
- 在所有患者中观察到GOO得分的显著改善.
结论:
- 在高风险患者中,EUS引导的LAMS安置为高风险患者的联合GOO和胆道阻塞提供了有效的治疗方法.
- 这种技术有助于成功的ERCP,解决黄和改善GOO.
- LAMS安置为管理GOO提供了持久的解决方案,并使未来的胆汁干预成为可能.
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