Heinerman M, Mann R, Boeckl O
Surgical Department I, Ludwig-Boltzmann-Institute for Experimental and Gastroenterological Surgery, Landeskrankenanstalten Salzburg, Austria.
Endoscopy. 1993 Mar;25(3):248-50. doi: 10.1055/s-2007-1010303.
This report describes a guidewire fracture during an attempt at endoscopic treatment of pancreatic duct calculi in a patient with chronic pancreatitis, multiple pancreatic duct stenoses and pancreatic duct stones. This patient underwent endoscopic sphincterotomy in order to perform pancreatic duct drainage prior to ESWL. After sphincterotomy, a guidewire was introduced into the main pancreatic duct, but was jammed by the calculi. Neither could the guidewire be removed nor a contrast medium catheter be pushed over it, thus making ESWL impossible. A stronger pull resulted in a fracture of the wire, and a 25 mm long part which could not be removed with a Dormia basket remained in the main pancreatic duct. A Whipple's procedure became necessary as definitive treatment for the pancreatico-lithiasis in this patient.
本报告描述了1例慢性胰腺炎、多发胰管狭窄并胰管结石患者在内镜治疗胰管结石过程中导丝断裂的情况。该患者在体外冲击波碎石术（ESWL）前接受了内镜括约肌切开术以进行胰管引流。括约肌切开术后，将一根导丝插入主胰管，但被结石卡住。既无法取出导丝，也无法将造影剂导管套在导丝上，从而使ESWL无法进行。用力牵拉导致导丝断裂，一段25毫米长、无法用多尔米亚网篮取出的导丝留在了主胰管内。该患者最终需要行惠普尔手术来治疗胰管结石。
