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一个成功的逐步内镜超声导向囊排水对于一个巨大的感染肝囊:一个案例报告
Kazuki Endo1, Haruo Miwa1, Shotaro Tsunoda1
1Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.
DEN open
|January 22, 2026
概括
巨型感染性肝囊可以有效地使用内镜超声波导向囊排水 (EUS-CD) 和当手术不可行时内部支架进行治疗. 这种方法为复杂的案件提供了安全和持久的解决方案.
科学领域:
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
- 干预性内镜检查是干预性的内镜检查.
背景情况:
- 巨型肝囊可能导致严重的并发症,包括胆道阻塞和感染.
- 感染性肝囊的管理,特别是压缩重要结构的大型肝囊,是一个临床挑战.
研究的目的:
- 评估内超声导向囊排水 (EUS-CD) 结合内部支架的疗效和安全性,用于管理巨型感染肝囊.
主要方法:
- 一名79岁的男性患有导致胆道炎的巨型肝囊,接受了初始鼻排水.
- 由于患者的病情不佳和穿皮排水的风险,进行了带有鼻囊排水的内超声导向囊排水 (EUS-CD).
- 在初始EUS-CD后,使用双pigtail支架进行内部跨内镜超声波引导创建路径 (ESCR) 排水,随后对复发性感染进行支架交换.
主要成果:
- 最初的EUS-CD和鼻囊排水改善了胆管炎.
- 转换为内部跨ESCR排水与支架解决了胆道压缩.
- 由于支架封闭而导致的反复感染需要支架更换和额外的ESCR排水,最终导致通过多个塑料支架持续控制感染.
结论:
- 透视超声导向囊排水 (EUS-CD),然后通过透视超声导向创建路径 (ESCR) 进行内部支架,是巨型感染肝囊的安全,有效和持久的治疗方法.
- 这种微创方法对于由于解剖复杂性或一般状况不佳而不适合穿皮排水或手术的患者尤其有价值.
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