Tam P C, Lai E C, Hui W M, Chan S C
Department of Surgery, Queen Mary Hospital, Hong Kong.
Am J Gastroenterol. 1990 Feb;85(2):207-9.
Percutaneously inserted transhepatic guide wire improves the success rate of endoscopic biliary stenting. However, we have encountered several pitfalls with this approach. In one patient, as a result of the stability provided by the transhepatic guide wire, the stent was pushed excessively into the liver parenchyma. In another patient, the proximal end of the stent was embedded in liver parenchyma in the lateral view during fluoroscopy, despite apparently good positioning in the anteroposterior view. Avoidance of central puncture during establishment of percutaneous transhepatic biliary drainage and checking two planes with fluoroscopy may help to reduce this risk. Close attention to these potential technical pitfalls would further improve the success rate of endoscopic biliary stenting.
经皮插入的经肝导丝可提高内镜下胆道支架置入的成功率。然而，我们在这种方法中遇到了几个陷阱。在一名患者中，由于经肝导丝提供的稳定性，支架被过度推入肝实质。在另一名患者中，尽管在前后位视图中定位明显良好，但在荧光透视的侧位视图中，支架近端嵌入肝实质。在建立经皮经肝胆道引流时避免中心穿刺并通过荧光透视检查两个平面可能有助于降低这种风险。密切关注这些潜在的技术陷阱将进一步提高内镜下胆道支架置入的成功率。
