Duodenal ESD: conquering difficulties.
Duodenal ESD: conquering difficulties.
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DOI：
10.1016/j.giec.2013.11.007
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发表时间：
2014-04-01
影响因子：
--
通讯作者：
Miura, Yoshimasa
中科院分区：
文献类型：
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作者：
Yamamoto, Hironori;Miura, Yoshimasa
十二指肠内镜下黏膜下剥离术（ESD）由于其独特的解剖结构，技术难度较大。风险包括术中并发症、延迟出血和穿孔。小口径尖端透明罩是有用的。粘膜下组织的机械拉伸允许在直接可视化粘膜下组织和血管的情况下安全剥离和有效预防出血，同时肌肉损伤最小。短的双气囊内窥镜可用于在远端十二指肠ESD中稳定控制内窥镜头端。在十二指肠ESD的选择应谨慎考虑手术的受益和风险。
Duodenal endoscopic submucosal dissection (ESD) is technically difficult due to the unique anatomic features. The risks include intraprocedural complications, delayed bleeding, and perforation. A small-caliber-tip transparent hood is useful. Mechanical stretching of the submucosal tissue allows safe dissection and effective prevention of bleeding with minimum muscle injury under direct visualization of the submucosal tissue and blood vessels. A short double-balloon endoscope is useful to stabilize control of the endoscope tip in distal duodenal ESD. Selection of ESD in the duodenum should be made cautiously considering both benefits and risks of the procedure.