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内镜逆行胰胆管造影术(ERCP)期间Dormia篮受阻,经腹腔镜胆管入路解决:病例报告

Dormia basket impacted during ERCP, resolved by laparoscopic bile duct approach: Case report.

作者信息

Vargas Ávila Arcenio Luis, Martin Perez Jesus Antonio, Vargas Flores Julian, Domínguez Rodríguez Jorge Alejandro, de Alba Cruz Israel, González Luna Josue Andres, Guerrero Galindo Luis Ángel, Cab Cesar Luis Antonio

机构信息

Department of Surgery, Hospital Regional "General Ignacio Zaragoza" ISSSTE, Ciudad de México, Mexico.

出版信息

Int J Surg Case Rep. 2021 Feb;79:62-66. doi: 10.1016/j.ijscr.2020.12.078. Epub 2021 Jan 2.

Abstract

INTRODUCTION

Endoscopic retrograde cholangiopancreatography (ERCP) is the method of choice for treating and removing common bile duct (CBD) stones with high success rates. Among the adverse effects, impaction of the Dormia basket when removing the stones is an unusual complication.

CASE PRESENTATION

Two cases of choledocholithiasis with endoscopic treatment by ERCP and Dormia basket impaction, resolved by a laparoscopic approach to the bile duct.

DISCUSSION

Laparoscopic common bile duct exploration (LCBDE) has been developed as a technique to treat choledocholithiasis and simultaneously vesicular lithiasis by laparoscopy. LCBDE can be by means of a transcystic approach or by choledochotomy. The success of the treatment depends on surgical experience and the availability of adequate equipment, with high effectiveness to eliminate CBD stones and a success rate greater than 95%, it is equally effective for the resolution of adverse events during ERCP.

CONCLUSION

LCBDE provides an alternative therapy where there is no other type of treatment for the resolution of complications of ERCP. It is a safe, effective and reliable technique with high success rates, which offers the benefits of a minimally invasive approach.

摘要

引言

内镜逆行胰胆管造影术(ERCP)是治疗和取出胆总管结石的首选方法,成功率很高。在其不良反应中,取石时Dormia网篮嵌顿是一种罕见的并发症。

病例报告

两例胆总管结石患者接受了ERCP内镜治疗及Dormia网篮嵌顿,通过腹腔镜胆管手术得以解决。

讨论

腹腔镜胆总管探查术(LCBDE)已发展成为一种通过腹腔镜治疗胆总管结石并同时治疗胆囊结石的技术。LCBDE可通过经胆囊途径或胆总管切开术进行。治疗的成功取决于手术经验和足够设备的可用性,其消除胆总管结石的有效性高,成功率超过95%,对解决ERCP期间的不良事件同样有效。

结论

对于ERCP并发症的解决,如果没有其他类型的治疗方法,LCBDE提供了一种替代疗法。它是一种安全、有效且可靠的技术,成功率高,具有微创方法的优点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/670f/7809167/820a7db5c1d6/gr1.jpg

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