Vilmann P, Hancke S, Pless T, Schell-Hincke J D, Henriksen F W
Dept. of Surgical Gastroenterology, Gentofte University Hospital, Hellerup, Denmark.
Endoscopy. 1998 Oct;30(8):730-3. doi: 10.1055/s-2007-1001399.
We report here the first case of a one-step endosonography(EUS)-guided pseudocyst drainage. A prototype large channel curved array echo endoscope (Pentax FG-38 UX) and a prototype delivery system for placement of an endoprosthesis was used for the procedure. The delivery system (GIP MedicinTechnik GmbH/Medi-Globe Corporation) consists of a handle part with a piston, a metal ring sheath, a plastic catheter with a diathermy needle and a double pigtail endoprosthesis (8.5 Fr). When mounted on the endoscope the endoprosthesis can be advanced out of the distal end of the endoscope. The introduction of the stent as well as the stent release can be monitored entirely by ultrasound. The procedure was tested in a 76-year-old woman with a pseudocyst measuring 60 mm in diameter located in the tail of the pancreas. The procedure was well tolerated by the patient, and there were no procedural complications. The advantage of a large channel echo endoscope and our new prototype delivery system is that the endoprosthesis can be inserted in to a pancreatic cyst guided exclusively by EUS without exchange of endoscopes, catheters or guide wires. Further studies are warranted.
我们在此报告首例一步式内镜超声（EUS）引导下假性囊肿引流术。该手术使用了一台原型大通道弯曲阵列超声内镜（宾得FG-38 UX）和一种用于放置内支架的原型输送系统。输送系统（GIP MedicinTechnik GmbH/Mediglobe公司）由带活塞的手柄部分、金属环鞘、带透热针的塑料导管和双猪尾内支架（8.5 Fr）组成。当安装在内镜上时，内支架可从内镜远端伸出。支架的置入以及支架释放可完全通过超声监测。该手术在一名76岁女性患者身上进行测试，其胰腺尾部有一个直径60 mm的假性囊肿。患者对该手术耐受性良好，且无手术并发症。大通道超声内镜和我们新的原型输送系统的优点是，内支架可仅在EUS引导下插入胰腺囊肿，而无需更换内镜、导管或导丝。有必要进行进一步研究。
