Sarkaria Savreet, Sundararajan Subha, Kahaleh Michel
Division of Gastroenterology & Hepatology, Weill Cornell Medical College, New York, NY 10021, USA.
Gastrointest Endosc Clin N Am. 2013 Apr;23(2):435-52. doi: 10.1016/j.giec.2012.12.013. Epub 2013 Jan 30.
Endoscopic retrograde cholangiopancreatography (ERCP) is currently the standard of care for biliary drainage. In the hands of experienced endoscopists, conventional ERCP has a failed cannulation rate of 3% to 5%. Failures have traditionally been referred for either percutaneous transhepatic biliary drainage (PTBD) or surgery. Both PTBD and surgery have higher than desirable complication rates. Endoscopic ultrasound-guided biliary drainage (EUS-BD) is a novel and attractive alternative after failed ERCP. Many groups have reported on the feasibility, efficacy, and safety of this technique. This article reviews the indications and technique currently practiced in EUS-BD, including EUS-guided rendezvous, EUS-guided choledochoduodenostomy, and EUS-guided hepaticogastrostomy.
内镜逆行胰胆管造影术（ERCP）目前是胆管引流的标准治疗方法。在经验丰富的内镜医师手中，传统ERCP的插管失败率为3%至5%。传统上，失败病例会转诊进行经皮肝穿胆管引流术（PTBD）或手术。PTBD和手术的并发症发生率均高于预期。内镜超声引导下胆管引流术（EUS-BD）是ERCP失败后的一种新颖且有吸引力的替代方法。许多研究小组都报道了该技术的可行性、有效性和安全性。本文综述了目前EUS-BD的适应证和技术，包括EUS引导下会师术、EUS引导下胆总管十二指肠吻合术和EUS引导下肝胃吻合术。
