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中华胃肠内镜电子杂志

中华胃肠内镜电子杂志 ›› 2023, Vol. 10 ›› Issue (04) : 271 -273. doi: 10.3877/cma.j.issn.2095-7157.2023.04.008

护理园地

肝门部胆管恶性狭窄内镜下采取不同放置方式同期置入胆道金属支架操作的配合体会
王淑萍, 张婷, 王坤可, 刘延廷, 张倩, 许丽君, 张世杰, 王圆圆, 胡冰, 高道键†()   
  1. 200438　上海，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
  • 收稿日期:2023-01-10 出版日期:2023-11-15
  • 通信作者: 高道键
  • 基金资助:
    上海市2022年度"科技创新行动计划"医学创新研究专项(22Y11909000)

Experience in the operation and coordination of different placement methods of metal biliary stents in malignant hilar bile duct stricture under endoscopy

Shuping Wang, Ting Zhang, Kunke Wang, Yanting Liu, Qian Zhang, Lijun Xu, Shijie Zhang, Yuanyuan Wang, Bing Hu, Daojian Gao†()   

  1. Department of Gastroenterology and Endoscopy Center, Third Affiliated Hospital of Naval Medical University, Shanghai 200438, China
  • Received:2023-01-10 Published:2023-11-15
  • Corresponding author: Daojian Gao
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引用本文：

王淑萍, 张婷, 王坤可, 刘延廷, 张倩, 许丽君, 张世杰, 王圆圆, 胡冰, 高道键. 肝门部胆管恶性狭窄内镜下采取不同放置方式同期置入胆道金属支架操作的配合体会[J]. 中华胃肠内镜电子杂志, 2023, 10(04): 271-273.

Shuping Wang, Ting Zhang, Kunke Wang, Yanting Liu, Qian Zhang, Lijun Xu, Shijie Zhang, Yuanyuan Wang, Bing Hu, Daojian Gao. Experience in the operation and coordination of different placement methods of metal biliary stents in malignant hilar bile duct stricture under endoscopy[J]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2023, 10(04): 271-273.

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。

关键词: 肝门部胆管恶性狭窄, 经内镜逆行胰胆管造影, 操作配合
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.

Key words: Malignant stricture of hilar bile duct, Endoscopic retrograde cholangiopancreatography, Operation cooperation
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