The extraction of difficult bile duct stones in a patient with surgically altered anatomy using a novel retrieval basket and a short-type single-balloon enteroscopy

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC
Masanari Sekine, Taku Mizutani, Ryo Hashimoto, Goya Sasaki, Azumi Sato, Shu Kojima, Keita Matsumoto, Takeshi Uehara, Takeharu Asano, Hirosato Mashima
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Abstract

Sekine and colleagues report successful stone extraction using a novel retrieval basket and a short-type single-balloon enteroscope in a patient with surgically altered anatomy. Its unique shape makes the basket with a 0.018-inch guidewire the first choice for removal of small bile duct stones in patients with surgically altered anatomy.

Abstract Image

使用新型取石篮和短型单气囊肠镜为一名解剖结构发生手术改变的患者取出疑难胆管结石
总胆管和肝内胆管结石一般通过内窥镜取出。1, 2 其中一个原因是,由于工作通道的长度和大小,可用于球囊肠镜的设备有限。据报道,一种具有独特螺旋形状的新型取石篮(VolticCatch V;日本东京奥林巴斯医疗系统公司;图 1)可用于使用工作通道直径为 3.7 毫米的结肠镜为 SAA 患者取出胆管结石。之前使用 0.018 英寸导丝的 VolticCatch V 型无法通过短型单气囊肠镜(SIF-H290S;奥林巴斯医疗系统公司)直径为 3.2 毫米、长 152 厘米的工作通道,例如在困难的情况下无法形成环路,但改进后的型号可以通过(图 2)。我们报告了两例 SAA 患者使用这种带有 0.018 英寸导丝的取石篮成功取出胆管结石的病例,由于其独特的形状,可能成为 SAA 患者取出小胆管结石的首选。插入线圈鞘时,0.018 英寸导丝在曲线上受到的阻力很大(箭头)。(b)改进模型:线圈鞘的顶部为圆形,尾部为方形。插入线圈鞘时,0.018 英寸导丝在曲线上的阻力减弱。患者因胃癌接受了全胃切除术,并进行了 Roux-en-Y 重建。使用 SIF-H290S 进行了内镜逆行胰胆管造影术(ERCP)。胆管造影显示多处缺损。我们使用了机械碎石机和球囊导管,但结石滑过了靠近乳头的篮子和球囊。因此,在将导丝从 0.025 英寸改为 0.018 英寸后,我们使用了一种新型篮筐。在另一个病例中,一名 25 岁的女性因先天性胆道扩张接受了胆总管空肠吻合术。ERCP使用SIF-H290S进行取石。胆管造影显示右肝管缺损。我们使用带有 0.018 英寸导丝的新型篮子,轻松取出了肝内胆管结石。
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来源期刊
CiteScore
7.20
自引率
4.30%
发文量
567
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