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布韦里综合征:病因、临床表现、鉴别诊断、并发症及治疗选择

Bouveret Syndrome: Etiology, Clinical Presentation, Differential Diagnosis, Complications, and Treatment Options.

作者信息

Thatipalli Nikhil, Gattani Rajesh, Nayak Krushank, Sudabattula Kesav

机构信息

General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Jul 17;16(7):e64754. doi: 10.7759/cureus.64754. eCollection 2024 Jul.

Abstract

Bouveret syndrome is one of the complications of gallstone disease possibly fatal, which proposes the presence of a large stone obliterating the lumen of the duodenum or stomach because of the formation of a bilioenteric fistula. This review article, therefore, plans to review the causes, patient characteristics, diagnostic workup, associated conditions, and treatment of Bouveret syndrome. A literature search was also performed through scientific databases such as Scopus, Google Scholar, and PubMed concerning articles related to Bouveret syndrome written by different authors. The terms employed for the search were bilioduodenal fistula, Bouveret syndrome, gastric outlet obstruction, and gallstone ileus. Both case reports and systematic reviews that were written in the English language and published between the years 2000 and 2024 were considered. Finally, the review establishes the relevant concerns surrounding the diagnosis of Bouveret syndrome, focusing on the diagnosing issues. It emphasises the need for some specialities' involvement and focuses on the importance of endoscopic intervention. For patients, endoscopy remains the first line of treatment, while surgery is necessary in cases where conservative methods cannot be used. The article also focuses on new approaches to treating the conditions, such as percutaneous gallbladder stone dissolution. Latterly, further developments in minimally invasive surgery pertain to refining methods, including endoscopic removal and lithotripsy, to improve the survival rate of patients. Further investigation is required, especially regarding the administration schedule in relation to this disorder and goals that can reduce mortality and morbidity, especially in elderly patients with comorbid diseases.

摘要

布韦雷综合征是胆石症的并发症之一,可能会致命,其病因是由于胆肠瘘的形成,导致一块大结石阻塞十二指肠或胃的管腔。因此,这篇综述文章计划回顾布韦雷综合征的病因、患者特征、诊断检查、相关病症及治疗方法。还通过Scopus、谷歌学术和PubMed等科学数据库,对不同作者撰写的与布韦雷综合征相关的文章进行了文献检索。检索所用的关键词为胆十二指肠瘘、布韦雷综合征、胃出口梗阻和胆石性肠梗阻。纳入了2000年至2024年间发表的英文病例报告和系统评价。最后,该综述确定了围绕布韦雷综合征诊断的相关问题,重点关注诊断问题。强调了一些专科参与的必要性,并着重指出了内镜干预的重要性。对于患者而言,内镜检查仍是一线治疗方法,而在无法采用保守方法的情况下则需要进行手术。文章还重点介绍了治疗该病症的新方法,如经皮胆囊结石溶解术。近来,微创手术的进一步发展涉及改进方法,包括内镜下取出和碎石术,以提高患者的生存率。还需要进一步研究,特别是关于该病症的给药方案以及可降低死亡率和发病率的目标,尤其是对于患有合并症的老年患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/101a/11329337/83b509c6648b/cureus-0016-00000064754-i01.jpg

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