Huang Jin, Wen Wei, Tang Xiaowei, Fan Zhining, Song Hanming, Wang Kuangjing
*Digestive Medical Center, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province †Division of Digestive Diseases, The People's Hospital of Ma Anshan, Ma Anshan City, Anhui Province, China.
Surg Laparosc Endosc Percutan Tech. 2014 Jun;24(3):e101-5. doi: 10.1097/SLE.0b013e318293c4b6.
BACKGROUND/AIMS: Esophageal perforation is a rare complication of endoscopic retrograde cholangiopancreatography and the perforation is usually too large to close with endoclips. We developed an endoscopic procedure for the perforations.
A gastroscope fitted with a cap was inserted into the esophagus to perform the clip closure. The closure procedure was divided in 3 steps: step 1 is large clip closure; step 2 is small clip closure; and step 3 is the nasogastric tube placement for drainage.
A total of 4 patients underwent a cap-assisted clip closure and the procedures were completed successfully within 30 minutes. The cure was achieved in all the 4 patients after a relatively short period of hospital stay and no patient complained of closure-related complication.
The cap-assisted clip closure procedure is effective, safe, and easy to carry out for the closure of large esophageal perforations. It may also be applied to perform the closure of large perforations at other sites of the digestive tract.
背景/目的：食管穿孔是内镜逆行胰胆管造影术的一种罕见并发症，且穿孔通常过大，无法用内镜夹闭合。我们开发了一种针对此类穿孔的内镜手术方法。
将装有帽的胃镜插入食管以进行夹闭。闭合过程分为3个步骤：步骤1是大夹子闭合；步骤2是小夹子闭合；步骤3是放置鼻胃管进行引流。
共有4例患者接受了帽辅助夹闭术，手术均在30分钟内成功完成。4例患者均在较短住院时间后治愈，且无患者抱怨与闭合相关的并发症。
帽辅助夹闭术对于闭合较大的食管穿孔有效、安全且易于实施。它也可应用于消化道其他部位较大穿孔的闭合。
