使用鼻排水管进行内镜超声导向约会的故障排除
Tomohiro Yamazaki1, Kenji Nakamura2, Yuichiro Suzuki1
1Department of Gastroenterology St. Luke's International Hospital Tokyo Japan.
DEN open
|November 5, 2025
概括
使用鼻排水管 (NBD) 进行内镜超声导向约会 (EUS-RV) 故障排除,成功地在患有解剖学困难的患者中完成了具有挑战性的胆管管道通道. 这种方法有助于在复杂的情况下对导线进行操作和维护.
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.
- 胆汁干预 胆汁干预
背景情况:
- 在ERCP期间选择性胆道管 (SBDC) 失效需要像EUS-RV.这样的替代技术.
- EUS-RV带来了独特的挑战,特别是在解剖学变异方面,如大周腹膜分泌体 (PAD) 和严重的胃瘤.
- 在导线操纵和维护方面的困难可能会延长EUS-RV程序.
研究的目的:
- 介绍使用鼻排水管 (NBD) 的EUS-RV新型故障排除方法.
- 在复杂的患者病例中,证明NBD在EUS-RV期间管理导线操纵和维护挑战中的有效性.
- 突出NBD作为干预工具的方便性和可用性.
主要方法:
- 在ERCP尝试失败后,EUS-RV在一个患有CBD石头,大PAD和严重胃瘤的患者身上进行.
- 在CBD中临时放置了一台5法式NBD,以方便导线操纵和维护.
- 在光学指导下进行的随后的食道胃管腺镜允许通过PAD将NBD插入十二指肠.
- 使用保留的NBD实现了SBDC,然后进行石头去除.
主要成果:
- 该患者出现了普通胆道 (CBD) 石头和解剖学挑战 (大PAD,严重胃) 阻碍了ERCP和初始EUS-RV尝试.
- 导线操纵和维护在EUS-RV期间受到PAD和胃瘤的显著挑战.
- 一个NBD的临时放置和随后的十二指肠插入使SBDC和石头的成功移除成为可能.
- 该NBD方便导线通过PAD,并保持其位置,尽管胃.
结论:
- 在复杂的情况下,使用鼻排水管 (NBD) 是用于内镜超声波引导约会 (EUS-RV) 的有效故障排除策略.
- NBD有助于克服导线操纵的困难,由外腹分离器 (PAD) 引起,并保持导线的位置在严重的胃缩.
- NBD是一种易于获得和方便的设备,用于管理具有挑战性的EUS-RV程序,提高选择性胆道管的成功率.
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