摘要
目的评估超声内镜引导下胆管引流(EUS-BD)对内镜逆行胰胆管造影(ERCP)失败的梗阻性黄疸患者的减黄效果。方法回顾性收集并分析2018年9月至2023年11月在北京友谊医院消化内镜中心因ERCP失败而行EUS-BD的梗阻性黄疸患者的临床资料,分析EUS-BD的技术成功率、临床成功率以及不良事件发生情况。结果39例患者共进行了43次EUS-BD术,技术成功率为86.0%(37/43)。临床成功率为81.1%(30/37),7例未有效实现胆管引流,包括死亡病例2例和术后复发性胆管梗阻5例。不良事件发生率为21.6%(8/37),包括术后胆汁渗漏性腹膜炎2例,支架移位2例,支架脱落1例,穿孔1例,死亡2例。结论EUS-BD是相对安全、有效的胆管引流方式,可以作为ERCP失败的梗阻性黄疸患者的可靠替代治疗方法。
Objective To assess the treatment outcomes of endoscopic ultrasound-guided biliary drainage(EUS-BD)in patients with obstructive jaundice due to unsuccessful endoscopic retrograde cholangiopancreatography(ERCP).Methods The clinical data of patients with obstructive jaundice who underwent EUS-BD due to ERCP failure at the Gastrointestinal Endoscopy Center of Beijing Friendship Hospital from September 2018 to November 2023,was retrospectively collected and analyzed.We explored the technical success,clinical success,and adverse events associated with EUS-BD.Results In total,43 EUS-BD procedures were performed in 39 patients with a technical success rate of 86.0%(37/43).The clinical success rate was 81.1%(30/37).Biliary drainage was not effectively achieved in seven cases,including two fatal cases and five cases of recurrent postoperative biliary obstruction.The incidence of adverse events was 21.6%(8/37),including two cases of postoperative bile leakage peritonitis,two cases of stent displacement,one case of stent dislocation,one case of perforation,and two cases of death.Conclusion EUS-BD is a relatively safe and effective method for bile duct drainage,serving as a dependable alternative therapeutic option for patients with obstructive jaundice due to unsuccessful ERCP.
作者
张果
赵桂平
梁正
张澍田
Zhang Guo;Zhao Guiping;Liang Zheng;Zhang Shutian(Department of Gastroenterology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《中华内科杂志》
CAS
CSCD
北大核心
2024年第10期975-981,共7页
Chinese Journal of Internal Medicine
关键词
超声检查
介入性
胰胆管造影术
内窥镜逆行
引流术
黄疸
Ultrasonography,interventional
Cholangiopancreatography,endoscopic retrograde
Drainage
Jaundice
