• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Endoscopy International Open >Endoscopic ultrasound-guided pancreatic duct intervention and pancreaticogastrostomy using a novel cross-platform technique with small-caliber devices
【24h】

Endoscopic ultrasound-guided pancreatic duct intervention and pancreaticogastrostomy using a novel cross-platform technique with small-caliber devices

机译：使用小口径装置的新型跨平台技术，内窥镜超声引导胰管干预和胰蛋白酶术

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background and study aims?Endoscopic ultrasound (EUS)-guided pancreaticogastrostomy (PG) has been used as an alternative to surgery to drain pancreatic ducts for treatment of disconnected pancreatic duct syndrome (DPDS). Previous techniques involved using needle-knife cautery, bougie dilation or a stent extraction screw to allow stent passage through the gastric wall and pancreatic parenchyma, with potential for severe complications including duct leak, especially if drainage fails. A novel technique employing EUS guided puncture of the main pancreatic duct (MPD) with a 19- or a 22-gauge needle, passage of an 0.018-guidewire, dilation of the tract with a small-diameter (4 F) angioplasty balloon and placement of 3F plastic stents with the pigtail curled inside the duct as an anchor. Methods?This is a retrospective case series at a single tertiary center. EUS-guided PG was considered when conventional endoscopic pancreatic duct drainage failed. Main outcomes included technical and clinic success and complications. Results?Eight patients underwent PG. Indications were DPDS (n?=?4), stenotic pancreaticoenteral anastomosis after Whipple procedure (n?=?3) and chronic pancreatitis with dilated MPD (n?=?1). Median MPD diameter was 6.75?mm [IQR 2.8?–?7.6]. Technical success was achieved in seven of eight cases (88?%); angioplasty balloon passed into the pancreatic duct in all accessed ducts. There was one asymptomatic duct leak, and no major or delayed complications, with clinical improvement (complete or partial) in five of eight (71?%). Conclusions?EUS-guided PG using a small-caliber guidewire, 4F angioplasty balloon, and reverse 3F single pigtail stents offers a safe and atraumatic alternative without use of cautery.
机译：背景和研究目标？内窥镜超声（EUS） - 导向胰蛋白酶术（PG）已被用作外科手术的替代方法，以排出胰管用于处理断开的胰管综合征（DPD）。以前的技术涉及使用针刀烧灼，Bougie扩张或支架萃取螺钉，以允许通过胃壁和胰腺的支架通道，具有严重的并发症，包括管道泄漏，特别是如果排水失败。一种新的技术，采用eus引导的主要胰腺导管（MPD）与19-或22尺度针，通过0.018导丝的通过，具有小直径（4 f）血管成形术球囊和放置在3F塑料支架与尾纤夹在管道内作为锚。方法是在单个三级中心的回顾性壳体系列。当传统的内窥镜胰管管导管引流失效时，考虑了令人调心的PG。主要结果包括技术和临床成功和并发症。结果？八名患者接受了PG。适应症是DPDS（n？=？4），旋转粉末过程（n？= 3）和慢性胰腺炎，慢性胰腺炎，具有扩张MPD（n？=？1）。中位MPD直径为6.75？mm [IQR 2.8吗？ - ？7.6]。技术成功在八种案件中有7例（88？％）;血管成形术球囊进入胰腺导管中的胰腺。有一种无症状的管道泄漏，没有主要或延迟的并发症，八分之一（71倍）中的五分之一（完全或部分）。结论？使用小口径导丝，4F血管成形术气球和反向3F单尾巴支架的EUS引导PG提供了安全和无创名制的替代品，而无需使用烧灼物。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号