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内镜逆行胰胆管造影术相关十二指肠穿孔预防与管理的最新进展

Recent advances in prevention and management of endoscopic retrograde cholangiopancreatography-related duodenal perforation.

作者信息

Zhu Guiying, Hu Fenglin, Wang Changmiao

机构信息

Department of General Surgery, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2021 Mar;16(1):19-29. doi: 10.5114/wiitm.2020.101025. Epub 2020 Nov 18.

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is the main diagnosis and treatment for biliary and pancreatic diseases; however, ERCP requires a high level of technical skill and experience, and there is always a risk of complications. ERCP-related duodenal perforation is one of the most serious complications of ERCP, and although the incidence rate is relatively low, the mortality rate is high. Recently, the introduction of new classification methods and the development of endoscopic technology and equipment have made endoscopic therapy a new trend. This may change the management strategy of perforation. Therefore, we reviewed the latest developments in endoscopic management, surgical management, and conservative internal medicine management. In addition to introducing many new endoscope treatment methods, we also discussed the timing of interventions, the progress of endoscope and surgical indications, and corresponding prevention strategies. We aim to retrospectively analyse these treatment modalities to propose appropriate solutions to improve dynamic clinical therapy.

摘要

内镜逆行胰胆管造影术(ERCP)是胆道和胰腺疾病的主要诊断和治疗方法;然而,ERCP需要高水平的技术技能和经验,并且始终存在并发症风险。ERCP相关十二指肠穿孔是ERCP最严重的并发症之一,尽管发病率相对较低,但死亡率很高。近年来,新分类方法的引入以及内镜技术和设备的发展使内镜治疗成为一种新趋势。这可能会改变穿孔的管理策略。因此,我们回顾了内镜管理、手术管理和保守内科管理的最新进展。除了介绍许多新的内镜治疗方法外,我们还讨论了干预时机、内镜和手术指征的进展以及相应的预防策略。我们旨在回顾性分析这些治疗方式,以提出适当的解决方案,改善动态临床治疗。

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