CAJ | 학술논문

目的探讨SpyGlass单人操作胆道镜系统在治疗胆胰疾病中的应用价值.方法选取巨大胆管结石患者4例,尚未确诊的胆管狭窄患者5例.对胆管巨大结石者,行SpyGlass直视下激光碎石治疗,常规取石.对胆管狭窄者,SpyGlass直视下观察病变情况,SpyBite活检钳直视下活检取样.患者均放置鼻胆引流管,术后检测血常规以及血尿淀粉酶,予抑酸、预防感染治疗.结果 9例患者均手术成功,平均SpyGlass操作时间21.2 min,平均总操作时间46.2 min.4例巨大胆管结石患者均成功完成碎石及取石,术后2d鼻胆管造影显示无结石残留.5例胆管狭窄患者,病理诊断胆管癌2例,胆管炎性狭窄3例.术后出现胰腺炎2例,均为轻度,经治疗后恢复.结论 SpyGlass单人操作胆道镜系统对于胆管疾病的诊治是较为安全有效的.
목적 탐토SpyGlass단인조작담도경계통재치료담이질병중적응용개치.방법 선취거대담관결석환자4례,상미학진적담관협착환자5례.대담관거대결석자,행SpyGlass직시하격광쇄석치료,상규취석.대담관협착자,SpyGlass직시하관찰병변정황,SpyBite활검겸직시하활검취양.환자균방치비담인류관,술후검측혈상규이급혈뇨정분매,여억산、예방감염치료.결과 9례환자균수술성공,평균SpyGlass조작시간21.2 min,평균총조작시간46.2 min.4례거대담관결석환자균성공완성쇄석급취석,술후2d비담관조영현시무결석잔류.5례담관협착환자,병리진단담관암2례,담관염성협착3례.술후출현이선염2례,균위경도,경치료후회복.결론 SpyGlass단인조작담도경계통대우담관질병적진치시교위안전유효적.
Objective To evaluate the clinical utility of SpyGlass single-operator ERCP-guided cholangiopancreatoscopy system for the diagnosis and treatment of bile duct disorders.Methods A total of 9 patients with biliary diseases were treated with SpyGlass single-operator ERCP-guided cholangiopancreatoscopy system.Four patients with large bile duct stones accepted laser lithotripsy,and stones were removed by ERCP.Five patients with indeterminate bile duct stricture accepted cholangioscopy-guided sampling.All patients underwent ENBD,routine blood test,blood amylase test,oral food and water restriction,acid suppression and prophylactic antibiotics.Results SpyGlass was successful in all patients with a manipulating time of 21.2min and total procedure time of 46.2min.Complete stone clearance was achieved in all 4 patients with large biliary stones.Sample quality was adequate in all patients with bile duct stricture with 2 patients diagnosed as having malignant biliary tumor and 3 as inflammatory bile duct stenosis.Post-ERCP complications including mild pancreatitis in 2 patients,and the patients recovered gradually after corresponding treatment.Conclusion ERCP-guided cholangiopancreatoscopy with the SpyGlass system is technically feasible and can be successfully and safely performed in patients with biliary disorders.