Iwashita Takuji, Lee John G
Division of Gastroenterology and Hepatology, H.H. Chao Comprehensive Digestive Disease Center, University of California, Irvine Medical Center, 101 The City Drive, Building 22C, First Floor, Orange, CA 92868, USA.
Gastrointest Endosc Clin N Am. 2012 Apr;22(2):249-58, viii-ix. doi: 10.1016/j.giec.2012.04.018. Epub 2012 May 9.
The success rate of deep biliary cannulation is high but still not perfect in endoscopic retrograde cholangiopancreatography (ERCP), even with aggressive techniques. With the development of linear-array echoendoscopes, the endoscopic ultrasonography-guided rendezvous technique (EUS-RV) has recently emerged as a salvage method for failed biliary cannulation. This review of current literature establishes that EUS-RV is a feasible and safe technique and should be considered as an alternative to percutaneous or surgical approaches. The availability of a percutaneous salvage (if EUS-RV fails) and well-trained endoscopists for both ERCP and EUS are mandatory in minimizing the potential complications of this procedure.
在经内镜逆行胰胆管造影术(ERCP)中,即使采用积极的技术,深部胆管插管的成功率虽高但仍不尽人意。随着线阵超声内镜的发展,内镜超声引导下会师技术(EUS-RV)近来已成为胆管插管失败后的一种补救方法。对当前文献的综述表明,EUS-RV是一种可行且安全的技术,应被视为经皮或手术方法的替代方案。为将该操作的潜在并发症降至最低,必须具备经皮补救措施(若EUS-RV失败),且要有训练有素的内镜医师同时擅长ERCP和EUS。