No nā poʻe maʻi me nā pseudocysts pancreatic, ʻoi aku ka maikaʻi o ka stent metala poʻo ʻelua hou.

ʻO ka pseudocyst pancreatic kekahi o nā hoʻopiʻi o ka maʻi pancreatitis, no ka mea, ʻo kāna mau hōʻailona hou he hopena koʻikoʻi i ka maikaʻi o ke ola o nā maʻi. I kēia manawa, ʻo nā ʻano lapaʻau no ka pancreatic pseudocysts e pili ana i ka hoʻomaʻamaʻa ʻana, ka wai hoʻoheheʻe percutaneous, a me ka drainage transluminal endoscopic. I nā makahiki i hala iho nei, ua lilo ka endoscopic transluminal drainage i ke ʻano lapaʻau maʻamau, alakaʻi nui ʻia e ka endoscopic ultrasound (EUS) e hoʻokumu i kahi kahawai wai kūpono ma waena o ka ʻōpū a me ka ʻōpū a i ʻole duodenum, i mea e hoʻokō ai i ka hoʻoheheʻe kūloko o ka cyst. I ka hoʻomaʻamaʻa lapaʻau, hoʻokomo pinepine ʻia nā ʻano stents ma waena o nā kahawai e hōʻoia i ko lākou kūlana wehe maikaʻi.

Aia nā ʻano stent i ka hoʻomaʻamaʻa lapaʻau, a ʻo ka stent pigtail pālua i hoʻohana pinepine ʻia he haʻahaʻa haʻahaʻa o ka neʻe ʻana o ka stent. Eia nō naʻe, ma muli o kona anawaena liʻiliʻi o loko, hiki pinepine ka stent blockage. Loaʻa i nā stents metala paʻa paʻa i uhi ʻia e like me ke anawaena nui o loko, ka haʻahaʻa haʻahaʻa o ka blockage, a me ka hopena hoʻokahe maikaʻi no nā cysts. I nā makahiki i hala iho nei, ua hoʻopuka ʻo South Korea i kahi ʻano hou o ka stent head mushroom head stent (Figure 1), ʻoi aku ka nui o ke anawaena a me ka lōʻihi, a ua hoʻolako ʻia me kahi catheter hoʻolaʻa. Ua ʻike ʻia nā haʻawina mua he ʻoi aku ka maikaʻi o kēia stent hou.

Hōʻike ʻia ʻo Cyst ma MR

Hoʻopiʻi ʻia ka ʻōpū o ka ʻōpū a liʻiliʻi

Pseudocyst ma lalo o ka ultrasound endoscopic

He kahe ka wai ma hope o ke kau ʻana i ka stent

Research Int roduction

Ua hōʻike ʻia kahi noiʻi ma South Korea no nā poʻe maʻi me nā pseudocysts pancreatic symptomatic, hiki i ka hoʻohana ʻana i kahi stent metala hou ʻelua mushroom head metal stent hiki ke hoʻohaʻahaʻa maikaʻi i nā hōʻailona, ​​​​e hoʻopau i nā cysts pancreatic, a palekana. Ua paʻi ʻia ka ʻatikala ma ka pukana Sepatemaba o Gastrointestinal Endoscopy (2019, 90 (3): 507-513).

Ua komo kēia haʻawina i nā poʻe maʻi me nā pseudocysts pancreatic symptomatic, ʻoi aku ka nui o ke anawaena ma mua o 6 knm, ʻaʻohe ʻāpana o loko, a pili pū me ka ʻōpū a me ka duodenal cavities. Hoʻokaʻawale i nā poʻe me nā mea paʻa i loko o nā pseudocysts, nā poʻe i make me nā lesions encapsulated, a me nā poʻe me nā pseudocysts hiki ʻole ke mālama ʻia ma lalo o ke alakaʻi ʻana o EUS. No nā poʻe maʻi i hoʻopaʻa inoa ʻia, ua hana ʻia ka ʻoki alakaʻi mua ʻana o ka EUS no ka hoʻokumu ʻana i kahi ala ma ka ʻōpū a i ʻole duodenal cavity a me ka cyst, a ukali ʻia e ka dilation a me ka hana hou ʻana a me ka hoʻokomo ʻana i kahi stent poʻo hou lua. Hana ʻia ʻo CT scan i nā pule he 4 ma hope o ka mālama ʻana e loiloi i ka hopena o ka hoʻokahe ʻana o ka cyst (Figure 2).

Kiʻi 2: Hoʻomaʻamaʻa ʻana i ka pseudocyst pancreatic me ka hoʻohana ʻana i kahi stent metala hou o ke poʻo mushroom hou: A, hōʻike ʻo CT i kahi pseudocyst pancreatic nui; B. EUS alakai transgastric cyst puncture oki; C. E nānā i ke kaula alakaʻi e komo ana i loko o ka cyst ma lalo o X-ray fluoroscopy; D. Hoʻokomo ʻana i ka stent SPAXUS ma lalo o ke alakaʻi ʻana o EUS; E. ʻIke ʻia kahi stent ma lalo o X-ray fluoroscopy; F. Ka nānā 'ana i ka stent i ho'okomo 'ia ma lalo o ka endoscopy pololei; ʻO G. CT nā kiʻi hahai ma hope o ka hoʻokomo ʻana i ka stent; H. Ma hope o ka hoʻokomo ʻana i ka stent, ua ʻike ʻia ka maikaʻi o ka hana stent ma lalo o ka endoscopy; I. Wehe i ka stent ma lalo o ka endoscopy

He 34 mau maʻi i kākau inoa ʻia i loko o ke aʻo ʻana, me 26 kāne a me 8 wahine, me ka awelika makahiki o 51.7 makahiki. ʻO ka awelika anawaena o nā pseudocysts pancreatic he 9.23 knm. Ma waho aʻe o ka mea maʻi i hāʻule i ke kaʻina hana hoʻokuʻu stent, ua hoʻopau maikaʻi nā maʻi 33 i koe i ka hoʻokomo ʻana i ka stent, me ka helu kūleʻa ʻenehana o 97.1% (33/34); Ma waena o nā maʻi 33 i hoʻokomo maikaʻi i ka stent, ʻo 1 wale nō ka mea maʻi i loaʻa ka hopena maikaʻi ʻole o ka wai, aʻo nā mea maʻi 32 i koe i loaʻa i ka hōʻoluʻolu o ka maʻi a me ka nalowale ʻana o ka cyst, me ka nui o ka holomua o ka maʻi o 94.1% (32/34). He 3 mau hihia o ka maʻi pseudocyst a me 1 hihia o ka stent dysfunction i ka wā perioperative, me ka helu hoʻopiʻi o 11.8% (4/34).

Nā ʻōlelo a ka poʻe akamai

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ʻO ka mea maʻamau, ʻo ka hapa nui o nā mea maʻi me nā pseudocysts pancreatic e koi i ka lāʻau lapaʻau no ka hoʻokō ʻana i ka wai a me ka hemo ʻana. Me ka hoʻomohala ʻana o ka ʻenehana endoscopic, ua lilo ka mālama endoscopic o nā pseudocysts pancreatic i ke ʻano o ka mālama ʻana, me ka maikaʻi a me ka palekana, akā aia kekahi mau pilikia ʻenehana.

ʻO ka hana nui o ka mālama ʻana i ka endoscopic no nā pseudocysts, ʻo ia ka hoʻokumu ʻana i kahi ala ma waena o ka lumen digestive tract a me ka cyst, a kau i kahi stent kūpono e hoʻokō i ka hoʻoheheʻe ʻana i loko o ka cyst. ʻO ke anawaena a me ka lōʻihi o ka stent e pili ana i ka hopena wai. I kēia manawa, ʻoi aku ka liʻiliʻi o ke anawaena o ka stent plastic pigtail pālua a hiki ke hoʻopaʻa ʻia; He pōkole ka lōʻihi o ka stent uhi ʻia a hiki ke hoʻoneʻe ʻia, e pili ana i ka hopena therapeutic; I kēia mau makahiki i hala iho nei, ʻoi aku ka nui o ke anawaena o loko o ka stent metala ʻelua i hoʻokuʻu ʻia a hiki ke hoʻololi ʻia i ka nui kūpono e like me ka lōʻihi o ka pā digestive a me ke kahawai cyst.

ʻO kēia haʻawina ka mua multicenter prospective study e kuhikuhi ana i ka stent novel, e manaʻo ana e loiloi i kona pono i nā maʻi me nā pseudocysts pancreatic symptomatic. Ua hoʻohana mua ka poʻe noiʻi i kahi nila puncture 19G EUS e hou ai i loko o ka cyst ma o ka paia ʻōpū a i ʻole duodenal. Ma hope o ka hoʻonui ʻia ʻana o ka baluna e hana i kahi ala kūpono kūpono, ua hoʻokomo ʻia kahi catheter kūpono a kau ʻia kahi stent. Ua loiloi ʻia ka hopena lapaʻau ma muli o ka hōʻoluʻolu ʻana o ka hōʻailona o ka mea maʻi a me nā loli i ke anawaena o ka cyst.