管理ERCP相关的钻孔:一个单一中心的经验
Nemanja Plecic1, Ana Malenkovic1, Aleksa Begovic1
1Digestive Endoscopy Department, University Clinic "Dr Dragisa Misovic-Dedinje", 11000 Belgrade, Serbia.
Journal of clinical medicine
|January 11, 2025
概括
内镜逆行胆血管细胞造影 (ERCP) 穿孔是罕见但严重的. 保守和内镜治疗对Stapfer II型穿孔显示出良好的结果,强调为最佳患者护理采用多学科方法.
科学领域:
- 胃肠病学 胃肠病学
- 内視鏡外科手術 內視鏡外科手術
- 手术并发症 手术并发症
背景情况:
- 穿孔是内镜逆流胆细胞造影 (ERCP) 的罕见但严重的并发症.
- 关于ERCP相关穿孔的最佳管理,目前还没有确立的共识.
- 这项研究评估了ERCP穿孔的发生率,管理和结果在一个中心.
研究的目的:
- 为了评估与ERCP相关的穿孔的发生率.
- 分析这些穿孔所采用的管理策略.
- 确定与不同管理方法相关的临床结果.
主要方法:
- 一个单一中心电子数据库的回顾性审查 (2018年10月 - 2023年6月).
- 使用Stapfer分类来识别和分类与ERCP相关的穿孔.
- 管理策略的分析,包括保守的,内镜和手术干预.
主要成果:
- 在619项手术中发生了8次与ERCP相关的穿孔 (1.29%).
- 观察到六个Stapfer II型和两个IV型穿孔.
- 在大多数患者 (87.5%) 中,保守管理是成功的,有些人接受了辅助内镜治疗;一名患者需要手术.
结论:
- 保守和内镜管理与Stapfer II型ERCP穿孔的良好结果有关.
- 在所有病例中都取得了成功的管理,平均住院时间为16.6天.
- 涉及内镜医生和肝胆外科医生的个性化,多学科的方法对于指导治疗决策至关重要.
相关概念视频
Esophageal Perforation-II: Clinical Manifestations and Management
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Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
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Endoscopic Procedures V: ERCP
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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...
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Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
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