Bassi Raghav, Macedo Francis I, Perbtani Yaseen, Brar Tony S
University of Central Florida College of Medicine, Graduate Medical Education/HCA Florida North Florida Hospital, Internal Medicine Residency Program, Gainesville, FL.
Division of Surgical Oncology, Department of Surgery, HCA Florida North Florida Hospital, Gainesville, FL.
ACG Case Rep J. 2024 Feb 28;11(3):e01290. doi: 10.14309/crj.0000000000001290. eCollection 2024 Mar.
Endoscopic ultrasound (EUS) is a diagnostic tool used to examine pancreatic lesions. In patients who have undergone Roux-en-Y gastric bypass, lesions of the pancreatic head can be difficult to access because of altered foregut anatomy. To access the excluded stomach for better visualization of the pancreatic head, EUS-directed transgastric intervention can be used in a 2-step fashion. We present an interesting case of a 62-year-old woman who underwent a single-session modified EUS-directed transgastric intervention with a fine needle biopsy of a pancreatic head mass. A novel through-the-scope suturing system, the X-tack system (Apollo Endosurgery, Austin, TX), was used to allow for a successful single-session procedure.
内镜超声（EUS）是一种用于检查胰腺病变的诊断工具。在接受了Roux-en-Y胃旁路手术的患者中，由于前肠解剖结构改变，胰头病变可能难以触及。为了进入旷置的胃以更好地观察胰头，EUS引导下的经胃介入可分两步进行。我们报告了一例有趣的病例，一名62岁女性接受了单期改良EUS引导下经胃介入及胰头肿块细针活检。使用了一种新型的经内镜缝合系统，即X-tack系统（阿波罗内镜手术公司，得克萨斯州奥斯汀），从而成功完成了单期手术。
