Endoscopic ultrasound-assisted transmural cholecystoduodenostomy or cholecystogastrostomy as a bridge for per-oral cholecystoscopy therapy using double-flanged fully covered metal stent.
Endoscopic ultrasound-assisted transmural cholecystoduodenostomy or cholecystogastrostomy as a bridge for per-oral cholecystoscopy therapy using double-flanged fully covered metal stent.
复制标题
超声内镜辅助透壁胆囊十二指肠吻合术或胆囊胃吻合术作为双法兰全覆盖金属支架经口胆囊镜治疗的桥梁
DOI：
10.1186/s12876-016-0420-9
复制
发表时间：
2016-01-19
影响因子：
2.4
通讯作者：
Wang G
中科院分区：
文献类型：
--
作者：
Ge N;Sun S;Sun S;Wang S;Liu X;Wang G
腹腔镜胆囊切除术（LC）已成为治疗症状性胆结石的“金标准”。正在引进创新的方法，这些程序包括经胃或经结肠内镜胆囊切除术。然而，在临床实施之前，仪器仍然需要修改，并且仍然需要更方便的治疗。此外，一些胆囊仍然具有良好的功能，胆囊切除术可能与各种并发症有关。本研究的目的是评价经胃肠道胆囊镜技术在非胆囊切除术的胆囊疾病的治疗。内镜超声（EUS）引导下胆囊十二指肠吻合术或胆囊胃吻合术，放置双凸缘全覆膜金属支架，并在此过程中对伴有胆总管结石的患者进行内镜括约肌切开术（EST）。1 ~ 2周后，取出支架，通过瘘管将内窥镜推进胆囊，进行胆囊结石切开术或息肉切除术。4周后用腹部超声检查胆囊。7例患者均成功行EUS引导下胆囊十二指肠吻合术（n = 3）或胆囊胃吻合术（n = 4）并放置双凸缘金属支架。手术后，每个患者都形成了瘘管，支架被取出。通过瘘口成功地进行了内镜胆囊切开取石术（7例）和息肉切除术（2例）。5例胆总管结石均取石成功。4周后的胆囊超声检查显示无结石残留，胆囊功能也令人满意。EUS引导放置新型金属支架是进行内镜胆囊十二指肠吻合术或胆囊胃吻合术的一种安全简单的方法，随后可以进行治疗胆道疾病的手术，包括胆囊取石术。
Laparoscopic cholecystectomy (LC) has become the ‘gold standard’ for the treatment of symptomatic gallstones. Innovative methods are being introduced, and these procedures include transgastric or transcolonic endoscopic cholecystectomy. However, before clinical implementation, instruments still need modification, and a more convenient treatment is still needed. Moreover, some gallbladders still have good functionality and cholecystectomy may be associated with various complications. The aim of this study was to evaluate the trans-gastrointestinal tract cholecystoscopy technique in the treatment of gallbladder disease without cholecystectomy. Endoscopic ultrasound (EUS)-guided cholecystoduodenostomy or cholecystogastrostomy with the placement of a double-flanged fully covered metal stent was performed and endoscopic sphincterotomy (EST) was also performed during this procedure for those patients with accompanying common bile duct stones. One or two weeks later the stent was removed and an endoscope was advanced into the gallbladder via the fistula, and cholecystolithotomy or polyp resection was performed. Four weeks later gallbladder was assessed by abdominal ultrasound. EUS guided cholecystoduodenostomy (n = 3) or cholecystogastrostomy (n = 4) with double flanged mental stent deployment was successfully performed in all of 7 patients. After the procedure, fistulas had formed in each of the patients and the stents were removed. Endoscopic cholecystolithotomy(7) and polyps resection(2) were successfully performed through the fistulas. Common bile duct stones were also successfully removed in 5 patients. The ultrasound examination of the gallbladder 4 weeks later showed no stones remaining and also showed satisfactory functioning of the gallbladder. The EUS-guided placement of a novel metal stent is a safe and simple approach for performing an endoscopic cholecystoduodenostomy or cholecystogastrostomy, which can subsequently allow procedures to be performed for treating biliary disease, including cholecystolithotomy.
影响因子：
4.5
作者：
Ang TL;Eu Kwek AB;Fock KM;Teo EK
通讯作者：
Teo EK
影响因子：
4.5
作者：
Altonbary AY;Deiab AG;Bahgat MH
通讯作者：
Bahgat MH