Puri Rajesh, Bhatia Sumit, Bansal Rinkesh K, Sud Randhir
Institute of Digestive and Hepatobiliary Sciences, Medanta The Medicity, Gurugram, India.
Endosc Int Open. 2018 Jul;6(7):E797-E800. doi: 10.1055/a-0624-2288. Epub 2018 Jul 4.
Endoscopic management using standard accessories is the preferred modality for treatment of benign biliary strictures. However, with difficult strictures, there is frequently failure of endoscopic therapy. We are reporting our experience regarding use of a standard diathermic dilator (cystotome) to aid in stricture dilatation and stent placement in patients with difficult strictures.
Data were analyzed from January 2014 to January 2017 at a single tertiary care center in North India. Total 25 patients were included.
The mean age was 45 years (varying from 38 - 55 years). Of the 25 patients with difficult strictures, 14 (56 %) were male and 11 (44 %) were female. Further, of these, 19 had biliary and 6 had pancreatic strictures. The average time of diathermic current application was 3.5 seconds (ranging 3 - 5 seconds). Technical and clinical success were achieved in 100 % of cases. None of the patients had any procedure-related (early or delayed) major complications.
The cystotome is an extremely safe and useful accessory in benign biliary and pancreatic strictures, whereas conventional methods to negotiate stricture have failed.
使用标准附件进行内镜治疗是良性胆管狭窄的首选治疗方式。然而，对于复杂狭窄，内镜治疗常常失败。我们报告了使用标准电凝扩张器（膀胱切开刀）辅助复杂狭窄患者进行狭窄扩张和支架置入的经验。
分析了2014年1月至2017年1月印度北部一家三级医疗中心的数据。共纳入25例患者。
平均年龄为45岁（38 - 55岁）。在25例复杂狭窄患者中，14例（56%）为男性，11例（44%）为女性。此外，其中19例为胆管狭窄，6例为胰腺狭窄。电凝电流的平均应用时间为3.5秒（3 - 5秒）。所有病例均取得了技术和临床成功。无一例患者出现任何与手术相关的（早期或延迟）严重并发症。
在常规方法处理狭窄失败时，膀胱切开刀是良性胆管和胰腺狭窄极为安全且有用的附件。
