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頁籤選單縮合
題名 | 內視鏡超音波導引之膽胰內視鏡治療=Endoscopic Ultrasound-guided Biliary and Pancreatic Duct Drainage |
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作者姓名(中文) | 李沐憲; 劉乃仁; | 書刊名 | 內科學誌 |
卷期 | 27:4 2016.08[民105.08] |
頁次 | 頁184-189 |
專輯 | 膽胰疾病之新進展 |
分類號 | 415.5091 |
關鍵詞 | 內視鏡超音波; 內視鏡逆行性膽胰道攝影; 膽管引流; 胰管引流; 膽胰道支架; Endoscopic ultrasound; Endoscopic retrograde cholangio-pancreatography; Biliary duct drainage; Pancreatic duct drainage; Biliary and pancreatic duct stent; |
語文 | 中文(Chinese) |
中文摘要 | 內視鏡超音波導引之膽胰內視鏡治療是在內視鏡逆行性膽胰道攝影失敗時除經皮穿肝引流及手術外一項有效且安全的替代方式。整體的技術及臨床成功率,在EUS-BD 有90% 成功率,在EUS-PDD 則有70%。整體的併發症約為15%。大部分的併發症都很輕微,但嚴重的併發症大多發生在胰管引流。和經皮穿肝引流相比,EUS- BD 有相似的引流效果,但相對有較高的安全率及成功率。在EUS-BD 方面,根據解剖位置的不同及是否內視鏡可達乳突,而有不同的選擇方式。在EUS-PDD 方面。相對trans-papillary/trans- anastomosis,以transluminal方式置放的支架可能有較多的術後併發症。目前此項技術仍具有挑戰性,需同時具有ERCP及EUS 經驗的醫師來執行,並建議有外科醫師來支援較佳。 目前適應症及引流方式尚未標準化,未來仍需更多的研究來改善流程及器械的使用。 |
英文摘要 | EUS-guided cholangio-pancreatic intervention is safe, efficacious, and a viable alternative to PTC or surgery in failed ERCP. The overall technical and clinical success rates are around 90% for biliary tree and 70% for pancreatic duct drainage. The overall EUS-CP complication rate was around 15%. Most of the complications are minor. However, severe complications can be encountered during pancreatic drainage. EUS-BD and PTBD appear to provide comparable efficacy, but EUS-BD may offer more safety and successful rate. In EUS-BD, there are diffident methods and procedures according to surgically altered anatomy and endoscopically accessible ampulla. In EUS-PDD, relative to trans-papillary or trans-anastomotic stents, trans- luminal stents are at a higher risk of stent migration and resultant leakage of pancreatic fluids. EUS-guided cholangio-pancreatic intervention is technical challenge and should be performed by an experienced endoscopist skilled in both EUS and ERCP. The indications and methods are not standard yet and need more pro-specific study to improve the methods/procedures and instruments. |
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