Yu Shan, Wang Xiao-Ming, Chen Xin, Xu Hong-Yan, Wang Guang-Jie, Ni Na, Sun Yu-Xin
Department of Gastroenterology, Panzhihua Central Hospital, Panzhihua 617067, Sichuan Province, China.
World J Gastroenterol. 2020 Aug 14;26(30):4557-4563. doi: 10.3748/wjg.v26.i30.4557.
At present, minimally invasive endoscopic treatment is mostly used for patients with actively bleeding Dieulafoy's lesions, , as it has the advantages of minimal trauma, short operation time and good hemostatic effect, although bleeding can easily recur postoperatively. Recently, extensive gastric cuneiform resection has been advocated for use in these patients because the constant-diameter artery follows a long path to the gastric mucosa.
A 47-year-old man was admitted to the hospital for repeated hematemesis and black stool, and he was diagnosed with Dieulafoy's disease. We chose a method that not only simulates surgical gastric cuneiform resection but also reduces trauma. We performed enlarged local endoscopic full-thickness resection of the gastric wall and abdominal constant-diameter artery and sutured the gastric wall. Postoperative follow-up showed that the constant-diameter artery had been resected from the gastric wall, which was confirmed to have no blood flow signals by endoscopic ultrasonography.
Endoscopic full-thickness resection of the gastric wall and abdominal constant-diameter artery with suturing of the gastric wall has demonstrated potential as a new treatment for Dieulafoy's disease.
目前,微创内镜治疗主要用于Dieulafoy病活动性出血患者,尽管术后出血容易复发,但因其具有创伤小、手术时间短和止血效果好等优点。最近,对于这些患者主张采用广泛的胃楔形切除术,因为恒定直径动脉通向胃黏膜的路径较长。
一名47岁男性因反复呕血和黑便入院,被诊断为Dieulafoy病。我们选择了一种既模拟手术胃楔形切除术又减少创伤的方法。我们进行了扩大的局部内镜下胃壁全层切除术及腹腔恒定直径动脉切除术,并缝合胃壁。术后随访显示,恒定直径动脉已从胃壁切除,经内镜超声检查证实无血流信号。
内镜下胃壁全层切除术及腹腔恒定直径动脉切除术并缝合胃壁已显示出作为Dieulafoy病新治疗方法的潜力。