Urgent endoscopic ultrasound-guided choledochoduodenostomy for acute obstructive suppurative cholangitis-induced sepsis
Urgent endoscopic ultrasound-guided choledochoduodenostomy for acute obstructive suppurative cholangitis-induced sepsis
复制标题
DOI：
10.3748/wjg.v22.i16.4264
复制
发表时间：
2016-04-28
影响因子：
4.3
通讯作者：
Kudo, Masatoshi
中科院分区：
文献类型：
--
作者：
Minaga, Kosuke;Kitano, Masayuki;Kudo, Masatoshi
急性梗阻性化脓性胆管炎（AOSC）由于胆道结石是一种危及生命的情况，需要紧急胆道减压。虽然内镜逆行胰胆管造影术（ERCP）和支架置入术是目前胆道减压的金标准，但由于胆管插管失败，有时会很困难。在这一回顾性病例系列中，我们描述了3例因胆管结石行AOSC紧急内镜超声引导下胆总管十二指肠吻合术（EUS-CDS）后成功引流并从感染性休克中恢复的病例。在所有3例病例中，均实现了支架插入的技术成功，患者在EUS-CDS后几天内完全从AOSC伴脓毒症中恢复。无手术相关并发症。当初始ERCP失败时，EUS-CDS可以成为一种有效的挽救生命的内镜胆管减压术，可缩短手术时间并预防ERCP后胰腺炎，特别是在AOSC诱导的脓毒症患者中。
Acute obstructive suppurative cholangitis (AOSC) due to biliary lithiasis is a life-threatening condition that requires urgent biliary decompression. Although endoscopic retrograde cholangiopancreatography (ERCP) with stent placement is the current gold standard for biliary decompression, it can sometimes be difficult because of failed biliary cannulation. In this retrospective case series, we describe three cases of successful biliary drainage with recovery from septic shock after urgent endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) was performed for AOSC due to biliary lithiasis. In all three cases, technical success in inserting the stents was achieved and the patients completely recovered from AOSC with sepsis in a few days after EUS-CDS. There were no procedure-related complications. When initial ERCP fails, EUS-CDS can be an effective life-saving endoscopic biliary decompression procedure that shortens the procedure time and prevents post-ERCP pancreatitis, particularly in patients with AOSC-induced sepsis.