胰十二指肠切除术后胆胰疾病消化内镜介入策略
Endoscopic intervention strategy for pancreaticoduodenectomy-related cholangiopancreatic diseases
Received date: 2023-06-06
Online published: 2023-10-24
胰十二指肠切除术后与胆胰管疾病相关的并发症有吻合口狭窄、胆/胰管结石、胆/胰管炎、肿瘤复发所致梗阻性黄疸等。因手术操作复杂、切除部位涉及多器官、并需消化道重建等因素,使术后内镜逆行胰胆管造影术面临巨大挑战。现介绍目前临床上常用的两种消化内镜介入策略(通过消化道经胆/胰肠吻合口逆行或使用超声内镜经食管壁、胃壁或空肠壁穿刺进入胆/胰管),为临床医师提供一定参考。
关键词: 内镜逆行胰胆管造影术; 胰十二指肠切除术; 单气囊小肠镜; 短型; 超声内镜引导
董元航, 陈洁 . 胰十二指肠切除术后胆胰疾病消化内镜介入策略[J]. 外科理论与实践, 2023 , 28(04) : 307 -309 . DOI: 10.16139/j.1007-9610.2023.04.006
The pancreaticoduodenectomy-related cholangiopancreatic complications include anastomotic stricture, cholangiopancreatic duct stones, cholangitis, pancreatitis, obstructive jaundice due to tumor recurrence, etc. Because of the complexity of the operation, the multiple organs involved and digestive tract reconstruction, endoscopic retrograde cholangio-pancreatography is difficult to carry out. In this article, we introduced two kinds of endoscopic interventional strategies, retrograde gastrostomy via biliary/pancreaticojejunostomy and endoscopic ultrasonography (EUS)-guided biliary drainage/ EUS-guided pancreatic drainage through digestive wall to provide some reference for clinicians.
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