Celiński K, Cichoz-Lach H
Department of Gastroenterology, Medical University of Lublin, Lublin, Poland.
J Physiol Pharmacol. 2007 Aug;58 Suppl 3:33-41.
The role of therapeutic endoscopy in current gastroenterology is very important. Therapuetic endoscopy is useful in treatment of gastrointestinal bleeding. Endoscopic control of gastrointestinal bleeding includes the following procedures of haemostasis techniques: photocoagulation, electrocoagulation, thermocoagulation and injection method. Owing to these procedures mortality has significantly decreased. Endoscopic hemostasis eliminates the risk of surgery, is less expensive and better tolerated by patients. Colonoscopic polypectomy is a widely used technique. By removal of polyps the incidence of colon cancer can be decreased. The "hot biopsy" forceps can be used to excise polyps of up to 6 mm. Larger polyps can be removed safely by snare electrocautery and retrieved for histologic study. Endoscopic retrograde cholangiopancreatography has a therapeutic application designed to cut the sphincter of Oddi fibers of the distal common bile duct, what is indicated currently in choledocholithiasis and papillary stenosis with ascending cholangitis, acute gallstone pancreatitis. Endoscopic sphincterotomy in now an established procedure that is indicated in patients with common bile duct calculi. Endoscopic decompression of the biliary tree - dilatation benign structures of the biliary tree with baloon catheters and placement an internal endoprothesis allows the nonoperative decompression and significant palliation for patients with obstructing tumors.
治疗性内镜在当前胃肠病学中作用非常重要。治疗性内镜在胃肠道出血治疗中很有用。胃肠道出血的内镜控制包括以下止血技术程序:光凝、电凝、热凝和注射法。由于这些程序,死亡率已显著降低。内镜止血消除了手术风险,成本更低且患者耐受性更好。结肠镜息肉切除术是一种广泛应用的技术。通过切除息肉可降低结肠癌的发病率。“热活检”钳可用于切除直径达6毫米的息肉。较大的息肉可通过圈套电灼安全切除并送检进行组织学研究。内镜逆行胰胆管造影术有一项治疗应用,旨在切断胆总管远端的Oddi括约肌纤维,目前适用于胆总管结石症以及伴有胆管炎、急性胆石性胰腺炎的乳头狭窄。内镜括约肌切开术现在是一种既定的手术,适用于胆总管结石患者。胆道树的内镜减压——用球囊导管扩张胆道树的良性结构并放置内支架,可为患有梗阻性肿瘤的患者实现非手术减压并显著缓解症状。