基于 SpyGlass 引导下的电液碎石术和胆囊十二指肠造口术(SLAMS)的联合疗法治疗米利兹综合征。

IF 1.3 4区 医学 Q4 GASTROENTEROLOGY & HEPATOLOGY Acta gastro-enterologica Belgica Pub Date : 2024-07-01 DOI:10.51821/87.3.12301
V VandenDriessche, P Yengue, J Collin, M Lefebvre
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引用次数: 0

摘要

米利兹综合征是慢性胆石症的一种罕见并发症,其特点是胆囊或胆囊管内的结石撞击导致胆总管受压。在本病例研究中,我们讨论了一名 85 岁的患者,她出现了米里兹综合征,并伴有脓毒性休克。由于年老体弱,她不符合胆囊切除术的条件,需要一种创伤较小的替代方案。通过内镜超声引导胆囊十二指肠造口术和腔内金属支架(LAMS),开始进行胆囊引流。利用该胆囊-胆囊支架,随后进行了SpyGlass引导电液碎石术(SGEHL),成功取出了多颗胆结石,其中包括一颗嵌顿在胆囊底腔的20毫米结石。随后,血清胆红素水平和炎症指标明显降低,与米利兹综合征的缓解相一致。SGEHL 和 LAMS(SLAMS)的结合代表了一种新的微创干预方法,可治疗这种可能危及生命的疾病。
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Combination therapy based on SpyGlass-guided electrohydraulic lithotripsy through cholecystoduodenostomy by lumen-apposing metal stent (SLAMS) for Mirizzi syndrome.

Mirizzi syndrome is a rare complication of chronic gallstone disease characterised by the compression of the common bile duct due to an impacted lithiasis in the infundibulum of the gallbladder or cystic duct. In this case study, we discuss an 85-yearold patient who presented with Mirizzi syndrome associated with septic shock. She was not eligible for cholecystectomy due to her advanced age and frailty, requiring a less invasive alternative. Gallbladder drainage was initiated by endoscopic ultrasoundguided cholecystoduodenostomy with a lumen-apposing metal stent (LAMS). Utilising this bulbo-cholecystic stent, SpyGlassguided electrohydraulic lithotripsy (SGEHL) was then performed, resulting in successful extraction of multiple bile stones, including a 20 mm lithiasis that was lodged in the cystic infundibulum. Subsequently, serum bilirubin levels and inflammatory markers were significantly reduced, consistent with resolution of Mirizzi syndrome. The combination of SGEHL and LAMS, designated as SLAMS, represents a novel, minimally invasive intervention for this potentially life-threatening disease.

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来源期刊
Acta gastro-enterologica Belgica
Acta gastro-enterologica Belgica Medicine-Gastroenterology
CiteScore
2.30
自引率
20.00%
发文量
78
期刊介绍: The Journal Acta Gastro-Enterologica Belgica principally publishes peer-reviewed original manuscripts, reviews, letters to editors, book reviews and guidelines in the field of clinical Gastroenterology and Hepatology, including digestive oncology, digestive pathology, as well as nutrition. Pure animal or in vitro work will not be considered for publication in the Journal. Translational research papers (including sections of animal or in vitro work) are considered by the Journal if they have a clear relationship to or relevance for clinical hepato-gastroenterology (screening, disease mechanisms and/or new therapies). Case reports and clinical images will be accepted if they represent an important contribution to the description, the pathogenesis or the treatment of a specific gastroenterology or liver problem. The language of the Journal is English. Papers from any country will be considered for publication. Manuscripts submitted to the Journal should not have been published previously (in English or any other language), nor should they be under consideration for publication elsewhere. Unsolicited papers are peer-reviewed before it is decided whether they should be accepted, rejected, or returned for revision. Manuscripts that do not meet the presentation criteria (as indicated below) will be returned to the authors. Papers that go too far beyond the scope of the journal will be also returned to the authors by the editorial board generally within 2 weeks. The Journal reserves the right to edit the language of papers accepted for publication for clarity and correctness, and to make formal changes to ensure compliance with AGEB’s style. Authors have the opportunity to review such changes in the proofs.
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An uncommon indication for liver transplantation: toxic epidermal necrolysis. An unusual case of high gastrointestinal bleeding after Whipple surgery. Are nucleot(s)ide analogues a negative factor for HBsAg seroconversion in acute hepatitis B? Bile acid malabsorption investigated by selenium-75-homocholic acid taurine (75SeHCAT) scans, a retrospective single-centre experience. Combination therapy based on SpyGlass-guided electrohydraulic lithotripsy through cholecystoduodenostomy by lumen-apposing metal stent (SLAMS) for Mirizzi syndrome.
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