医学
十二指肠大乳头
内镜逆行胰胆管造影术
内镜超声检查
经皮
放射科
胰腺炎
胰管
胆囊
胆道引流
胆管
排水
支架
普通外科
内窥镜检查
外科
生物
生态学
作者
Vinay Dhir,Hiroyuki Isayama,Takao Itoi,Majid A Almadi,Aroon Siripun,Anthony Y. Teoh,Khek Yu Ho
摘要
Drainage of obstructed bile duct and pancreatic duct under endoscopic ultrasonography (EUS) guidance has evolved into viable techniques suitable for patients with failed endoscopic retrograde cholangiopancreatography (ERCP) and/or altered surgical anatomy. One of the major advantages of EUS guidance is the possibility of multiple access points depending upon patient and ductal anatomy. Unlike ERCP, an approachable papilla is not a requisite for successful EUS‐guided biliary or pancreatic ductal drainage. Moreover, as the access is away from the papilla, there is the possibility of reduced pancreatitis. A variety of procedures have become available for EUS‐guided drainage, and it is important to develop standard terminology and procedural details. EUS‐specific stents, including lumen‐apposing metal stents have recently become available, and are likely to impact the outcomes of these procedures. Available data show a high success rate and acceptable adverse event rate for EUS‐guided biliary drainage. Success rate appears to be low for pancreatic duct drainage because of a variety of reasons. Outcomes of EUS‐guided biliary drainage appear equivalent to percutaneous drainage and ERCP. EUS‐guided gallbladder drainage appears promising for patients requiring gallbladder drainage but unfit for surgery. Further large controlled studies are needed to evaluate the exact role of these procedures.
科研通智能强力驱动
Strongly Powered by AbleSci AI