A novel technique for treatment ofintrahepatic biliary obstructionusing endobronchial ultrasoundsystem.
A novel technique for treatment ofintrahepatic biliary obstructionusing endobronchial ultrasoundsystem.
复制标题
使用支气管内超声系统治疗肝内胆道梗阻的新技术。
DOI：
10.1007/s12328-012-0299-0
复制
发表时间：
2012
影响因子：
1
通讯作者：
Baba H
中科院分区：
文献类型：
--
作者：
Chikamoto A;Nakahara O;Abe S;ImaiK;Nitta H;Hayashi H;Ikuta Y;Doi K,Ishiko T;Takamori H;Beppu T;Baba H
胆道梗阻（BO）是肝胆外科手术后的并发症之一，严重影响患者的生活质量.现有的介入方法，如内镜逆行胆管引流，偶尔不能治疗这种情况。这是使用支气管内超声（EBUS）系统治疗BO的第一份报告。一名65岁女性在因肝细胞癌行扩大右肝切除术后，在肝第3段（B3）和第2段（B2）的胆管汇合处发生BO。通过B3进行经皮经鞘胆道引流（PTBD），并将其瘘口扩张至18 Fr PTBD硅胶导管的大小。通过扩张的PTBD路径插入EBUS内窥镜。B2通过EBUS内窥镜在梗阻前插入B3，用细针抽吸活检针穿刺。通过针将导丝插入胆总管，并沿导丝放置7.2 Fr PTBD导管。夹闭插入的PTBD导管，建立胆道内引流。导管通畅24个月，患者未发生黄疸或胆管炎。这种使用EBUS系统的技术可以作为BO的治疗选择。
Biliary obstruction (BO) is one of the complications after hepatobiliary surgery decreasing patients’ quality of life. Existing interventional methods, such as endoscopic retrograde biliary drainage, occasionally fail to treat this condition. This is the first report of treatment of BO using an endobronchial ultrasound (EBUS) system. A 65-year-old woman developed BO at the confluence of the bile duct of segment 3 of the liver (B3) and segment 2 (B2) after extended right hepatectomy for hepatocellular carcinoma. Percutaneous transhepatic biliary drainage (PTBD) was performed through B3, and its fistula was dilated up to the size of an 18-Fr PTBD silicone catheter. An EBUS endoscope was inserted through the dilated PTBD route. B2 was punctured through the EBUS endoscope inserted to B3 just before the obstruction with a needle for fine-needle aspiration biopsy. A guidewire was inserted to the common bile duct through the needle, and a 7.2-Fr PTBD catheter was placed over the guidewire. The inserted PTBD catheter was clamped, and internal biliary drainage was established. The catheter was patent for 24 months, and the patient had no episodes of jaundice or cholangitis. This technique using the EBUS system can be a treatment option for BO.