胰空肠吻合口狭窄患者成功的内镜下近端移位胰腺支架取出。

Journal of rural medicine : JRM Pub Date : 2022-10-01 Epub Date: 2022-10-22 DOI:10.2185/jrm.2022-012
Sho Kitagawa
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引用次数: 0

摘要

目的:我们报告一例成功的内镜下通过胰空肠吻合术取出近端(上游)迁移的胰腺支架。患者:71岁男性,就诊前41个月因胆管癌行胰十二指肠切除术合并改良Child重建术合并胰内导管支架置入术,转至我科治疗急性胰腺炎。内镜下支架取出使用带透明罩的短型单球囊肠镜。胰空肠吻合被确定为埋在肠褶皱内的针孔状开口,并使用球囊导管扩张。最后,使用金属丝引导的篮式导管成功取出移位的胰腺支架,无并发症。结论:胰十二指肠切除术后,即使在胰空肠吻合术狭窄的情况下,也应尝试内镜下取出近端移位的胰腺支架,以避免高侵入性手术,包括手术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Successful endoscopic retrieval of a proximally migrated pancreatic stent in a patient with pancreaticojejunal anastomotic stenosis.

Successful endoscopic retrieval of a proximally migrated pancreatic stent in a patient with pancreaticojejunal anastomotic stenosis.

Successful endoscopic retrieval of a proximally migrated pancreatic stent in a patient with pancreaticojejunal anastomotic stenosis.

Successful endoscopic retrieval of a proximally migrated pancreatic stent in a patient with pancreaticojejunal anastomotic stenosis.

Objective: We report a case of successful endoscopic retrieval of a proximal (upstream) migrated pancreatic stent through a pancreaticojejunal anastomosis. Patient: A 71-year-old man with a history of pancreatoduodenectomy with modified Child's reconstruction and concomitant internal pancreatic ductal stenting for cholangiocarcinoma 41 months before presentation, was referred to our department for the treatment of acute pancreatitis. Endoscopic stent retrieval was performed using a short-type single-balloon enteroscope with a transparent hood. A pancreaticojejunal anastomosis was identified as a pinhole-like opening buried within the intestinal folds and dilated using a balloon catheter. Finally, the migrated pancreatic stent was successfully retrieved using a wire-guided basket catheter, without complications. Conclusion: Endoscopic retrieval of a proximally migrated pancreatic stent after pancreatoduodenectomy should be attempted, even in cases of stenotic pancreaticojejunal anastomosis, to avoid highly invasive procedures, including surgery.

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