Ban Tesshin, Kubota Yoshimasa, Takahama Takuya, Ando Tomoaki, Joh Takashi
Department of Gastroenterology and Hepatology Gamagori Municipal Hospital Aichi Japan.
DEN Open. 2021 Dec 24;2(1):e78. doi: 10.1002/deo2.78. eCollection 2022 Apr.
Endoscopic transpapillary gallbladder drainage is an alternative procedure for patients with acute cholecystitis. However, this procedure is technically challenging because the drainage stent is sometimes obstructed by an impacted cystic duct stone, even if the guidewire is advanced into the gallbladder. In this report, the front end of a standard endoscopic retrograde cholangiopancreatography catheter was cut to an appropriate length as a drainage stent for transpapillary gallbladder drainage. However, this modified stent became stuck because of an impacted cystic duct stone. The Soehendra stent retriever was used as a stent delivery device in this setting. A Soehendra stent retriever with clockwise rotation was coupled with the drainage stent. Integrated devices provide a stent tip for pushability and torqueability. The stuck drainage stent at the impacted cystic duct stone resumed advancement into the gallbladder. After stent indwelling, decoupling was easy under counterclockwise rotation of the Soehendra stent retriever.
内镜经乳头胆囊引流术是急性胆囊炎患者的一种替代手术。然而，该手术在技术上具有挑战性，因为即使导丝已进入胆囊，引流支架有时仍会被嵌顿的胆囊管结石阻塞。在本报告中，将标准内镜逆行胰胆管造影导管的前端切割至适当长度，作为经乳头胆囊引流的引流支架。然而，这种改良支架因嵌顿的胆囊管结石而卡住。在这种情况下，使用索恩德拉支架取出器作为支架输送装置。将顺时针旋转的索恩德拉支架取出器与引流支架相连。一体化装置提供了具有可推性和可扭转性的支架尖端。嵌顿在胆囊管结石处的卡住的引流支架恢复向胆囊推进。支架留置后，在索恩德拉支架取出器逆时针旋转的情况下很容易解耦。
