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在急性胰腺炎后进行内镜升级治疗

Shuntaro Mukai¹, Atsushi Sofuni¹, Takayoshi Tsuchiya¹

¹Department of Gastroenterology and Hepatology Tokyo Medical University Tokyo Japan.

|August 27, 2025

概括

最少的侵入性内镜治疗,包括内镜超声导向排水和内镜内切除术 (LAMS),为胰腺炎后的症状隔离性死亡提供了有效的选择.

科学领域:

胃肠病学
干预性内镜
胰腺疾病

背景情况:

晚期死亡的致死性胰腺炎,特别是感染性亡,仍然是一个重要的临床挑战.
有症状的隔离性亡 (WON) 需要侵入性干预,通常需要逐步升级的治疗策略.
起初最好采用最少的侵入性方法,如果初步治疗不足,则可升级为更具侵入性的方法.

研究的目的:

审查当前治疗症状隔离性瘤的干预策略.
评估内镜治疗方法的有效性和局限性
讨论金属支架 (LAMS) 和较新的内镜技术的作用.

主要方法:

对症状性WON的干预策略的当前文献的审查.
专注于内镜升级方法,包括内镜超声波导向排水和内镜尸切除术 (EN).
讨论对光线施加的金属支架 (LAMS),多个透光通道和透排水技术.

主要成果:

透视升级方法,特别是透视超声波导向排水和使用LAMS的EN,显示出有利的结果.
虽然LAMS可以增强排水和促进EN,但出血和与支架相关的不良事件可能是令人担忧的.
复杂的WON病例中,先进的技术,如多个透光通道和透囊排水,可以改善结果.

结论:

仅使用内镜治疗,使用LAMS和先进的排水技术,可以成功治疗大多数WON病例.
内镜治疗对盆腔的干扰有局限性,需要考虑通过皮肤或手术的综合方法.
对症状性WON来说,建议采用逐步的方法,优先考虑最少的侵入性内镜干预.

关键词:

内镜切除术用内镜超声波引导的胰腺液收集排水光装置的金属支架一步一步的方法隔墙性亡

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