摘要
目的:探讨肝门部胆管恶性狭窄内镜下同期置入胆道双金属支架并采取不同放置方式的操作配合与技巧。方法:收集海军军医大学第三附属医院(上海东方肝胆外科医院)内镜科2021年1月至2021年12月因肝门部胆管恶性狭窄拟接受内镜下同期胆道双金属支架置入术79例患者的病例资料。总结分析经内镜同期置入胆道双金属支架操作前、操作中和操作后的操作配合技巧。结果:77例患者经术前评估后拟行内镜下置入胆道双侧金属支架，77例患者成功置入胆道双侧金属支架后发生并发症的5例，其中胆管炎3例、胰腺炎1例、十二指肠乳头切缘出血1例，并发症发生率为6.49%。结论:规范化操作及熟练的操作配合技巧对内镜下同期置入胆道双金属支架起到重要作用。配合者应具备丰富的操作经验、理论知识扎实并熟知医师的操作意图，不仅能缩短操作时间，提高操作成功率，还能降低术后并发症的发生概率。
Abstract
Objective:To explore the operation cooperation and skills of simultaneous placement of biliary bimetallic stent anddifferent placement methods under endoscopic for malignant stricture ofhilar bile duct.Methods:The clinical data of 79 patients with malignant stricture of hilar bile duct who were planned to undergo simultaneous endoscopic biliary stent implantation were collected from January 2021 to December 2021 in the Endoscopic Department of the Third Affiliated Hospital of Naval Medical University (Shanghai Eastern Hepatobiliary Surgery Hospital). To summarize and analyze the operation cooperation skills before, during and after the simultaneous placement of biliary bimetallic stent via endoscope.Results:After preoperative evaluation, 77 patients were planned to undergo endoscopic placement of bilateral biliary metallic stent.Five of the 77 patients had complications after successful placement of bilateral metallic stent in the biliary tract, including 3 cases of cholangitis, 1 case of pancreatitis, and 1 case of bleeding at the cutting edge of duodenal papilla, with a complication rate of 6.49%.Conclusion:Standardized operation and skilled operation cooperation skills play an important role in the success of endoscopic simultaneous placement of biliary bimetallic stent. The cooperator has rich operation experience, solid theoretical knowledge and familiar with the doctor′s operation intention, which can not only shorten the operation time, improve the operation success rate, but also reduce the probability of postoperative complications.
基金项目
上海市202"科技创新行动计划"医学创新研究专项(22Y11909000)
万方数据