内镜逆行胰胆管造影术期间因导管操作导致胆总管结石移入主胰管
Migration of a Common Bile Duct Stone into the Main Pancreatic Duct due to Catheter Manipulation during Endoscopic Retrograde Cholangiopancreatography.
作者信息
Murabayashi Toji, Nakamura Haruka, Sugimoto Shinya
机构信息
Department of Gastroenterology, Ise Red Cross Hospital, Ise, Japan.
出版信息
Case Rep Gastroenterol. 2024 Mar 26;18(1):161-166. doi: 10.1159/000538009. eCollection 2024 Jan-Dec.
INTRODUCTION
We report the first case of a choledocholithiasis migrating into the main pancreatic duct (MPD) due to catheter manipulation during endoscopic retrograde cholangiopancreatography (ERCP).
CASE PRESENTATION
A 57-year-old woman complaining of vomiting was diagnosed with acute cholangitis and pancreatitis due to choledocholithiasis. During ERCP, the stone migrated from the papilla into the MPD due to the pushing motion of the catheter. However, the ERCP session was completed after biliary sphincterotomy without intervention in the MPD because the migration was not noticed. The migrated stone became apparent on computed tomography the following day. The second ERCP revealed the stone measuring 5 mm in the MPD. After pancreatic sphincterotomy, a pancreatic stent was placed, which improved the obstructive pancreatitis.
CONCLUSION
Endoscopists performing ERCP should be aware of this rare but serious complication.
引言
我们报告了首例因内镜逆行胰胆管造影术（ERCP）期间导管操作导致胆总管结石移入主胰管（MPD）的病例。
病例介绍
一名57岁女性因呕吐就诊，被诊断为胆总管结石所致急性胆管炎和胰腺炎。在ERCP期间，由于导管的推动动作，结石从乳头移入主胰管。然而，由于未注意到结石的移位，在未对主胰管进行干预的情况下，在胆管括约肌切开术后完成了ERCP操作。次日，计算机断层扫描显示了移位的结石。第二次ERCP显示主胰管内有一颗5毫米的结石。在进行胰管括约肌切开术后，放置了胰管支架，改善了梗阻性胰腺炎。
结论
进行ERCP的内镜医师应意识到这种罕见但严重的并发症。
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