胆道镜辅助激光碎石治疗胆囊切除术后Mirizzi综合征:病例系列

IF 1.5 Q3 GASTROENTEROLOGY & HEPATOLOGY Gastroenterology Insights Pub Date : 2023-03-06 DOI:10.3390/gastroent14010009
Bozhidar Hristov, D. Doykov, V. Andonov, Deyan Radev, K. Kraev, P. Uchikov, G. Kostov, Siyana Valova, E. Tilkiyan, K. Doykova
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引用次数: 0

摘要

介绍。Mirizzi综合征(MS)是一种罕见的临床症状,由胆囊或胆囊管的一个或多个结石嵌塞导致肝总管或胆总管(CBD)部分或完全阻塞引起。虽然在一个多世纪前被描述,多发性硬化症仍然是胆道病理谱中最具挑战性的疾病之一。近年来,内镜治疗已成为一种日益流行的治疗方式。患者和方法。对连续3例接受胆管镜辅助激光碎石治疗胆囊切除术后多发性硬化(pMS)的患者进行回顾性评价。案例报告。所有患者在一到两个疗程内成功清除了囊管。观察到一例并发症为轻度胆管炎。临床成功率为100%。讨论。根据目前的研究,CA-LL在经前综合症患者中获得了较高的导管清除率和可接受的并发症发生率。250µm激光光纤似乎是CA-LL的最佳选择。我们的研究结果表明,手术时间与结石大小密切相关,也可能与操作者的经验有关。在我们看来,在获得成功的导管清除和引流后,预防性支架置入并不能改善临床结果。结论。我们的研究结果表明CA-LL是一种安全有效的治疗经前综合症的方法。
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Cholangioscopy-Assisted Laser Lithotripsy for Treatment of Postcholecystectomy Mirizzi Syndrome: Case Series
Introduction. Mirizzi syndrome (MS) represents a rare clinical entity caused by impaction of one or multiple stones in the infundibulum of the gall bladder or the cystic duct resulting in partial or complete obstruction of the common hepatic or common bile duct (CBD). Though described more than a century ago, MS is still one of the most challenging diseases in the spectrum of biliary pathology. In recent years, endoscopic treatment has become an increasingly popular treatment modality. Patients and methods. Three consecutive patients subjected to cholangioscopy-assisted laser lithotripsy (CA-LL) for postocholecystectomy MS (pMS) were retrospectively evaluated. Case reports. Successful clearance of the cystic duct was achieved in all patients in one or two sessions. One complication in the form of mild cholangitis was observed. Clinical success was 100%. Discussion. According to current research, CA-LL achieves a high rate of ductal clearance and acceptable complication rate in patients with pMS. A 250 µm laser fiber seems to be the optimal choice for CA-LL. Our results suggest that procedure duration is closely associated to the stone size and possibly to the operator experience. In our opinion, upon obtainment of successful ductal clearance and drainage, prophylactic stenting does not improve clinical outcome. Conclusions. Our results demonstrate that CA-LL is a safe and effective treatment for pMS.
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来源期刊
Gastroenterology Insights
Gastroenterology Insights GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
2.80
自引率
3.40%
发文量
35
审稿时长
10 weeks
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