下注射以促进针刀缩术:一种新的技术
Kambiz Kadkhodayan1, Shayan Irani2, Sagar Pathak1
1Center for Interventional Endoscopy, AdventHealth, Orlando, Florida, USA.
概括
粘膜下染料注射改善了针刀缩术 (NKS) 期间的可视化,这是一种用于胆道通道的救援技术. 这种新的方法增强了解剖平面的分化,有助于控制剖析,并在具有挑战性的情况下防止不良事件.
科学领域:
- 胃肠病学 胃肠病学
- 内視鏡逆行性胆血管體攝影 (ERCP)
- 干预性内镜检查是干预性的内镜检查.
背景情况:
- 针刀切除术 (NKS) 是胆道通道的关键救援技术.
- 平板 (类型1) 囊对NKS构成挑战,由于组织平面可视化不佳,增加了出血和穿孔的风险.
- 在NKS期间的不良事件通常与区分解剖平面的困难有关.
研究的目的:
- 描述一种新的技术,使用粘膜下染料注射来改善NKS期间的可视化.
- 为了证明粘膜下染料注射在NKS程序中增强解剖平面分化的实用性.
- 介绍一个成功的NKS的案例研究,用于难以进入胆道的粘膜下染料注射.
主要方法:
- 一名59岁的胰腺癌和阻塞性黄的女性患者接受了ERCP.
- 由于平坦的囊,标准的膜切除术失败了;采用了带有下粘膜升降的NKS.
- 用三毫升的甲基蓝的甲基粉被注射到下,从而产生升高,随后进行了受控的剖析.
主要成果:
- 用甲蓝注射甲粉在下,成功地产生了足够的下提升.
- 进行了层层的剖析,实现了胆道的深度管.
- 该程序在没有任何不良事件 (如出血或穿孔) 的情况下完成.
结论:
- 粘膜下染料注射显著提高了在NKS期间解剖平面的可视化.
- 这种技术可以进行受控,解剖学指导的剖析,提高安全性和有效性.
- 粘膜下染料注射是对具有挑战性的NKS程序的宝贵补充,特别是在使用平 ampullae 的情况下.
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