恶性胆道梗阻经鼻胆引流管引导置入金属支架1例报道

Malignant biliary obstruction with metallic stent guided by nasobiliary drainage tube:one case report

恶性胆道梗阻是梗阻性黄疸的一种常见类型。ERCP胆道引流是缓解梗阻性黄疸一种重要的治疗手段,其中导丝能否越过胆道狭窄段进入扩张段是ERCP诊疗成败的关键,但在恶性胆道梗阻时胆管组织解剖已发生改变,导丝有时无法越过狭窄段或进入扩张胆管,致使手术失败。本文通过1例胰腺癌并梗阻性黄疸患者行ERCP治疗过程中出现的问题、意外以及解决的方案,初步探索鼻胆引流管引导导丝这种新的方式在插管失败的恶性胆道梗阻ERCP诊疗中的应用。

Malignant biliary obstruction is a common type of obstructive jaundice.ERCP biliary drainage is an important treatment to alleviate obstructive jaundice.Whether the guide wire can cross the narrow segment of the biliary tract into the dilated segment is the key to the success of ERCP diagnosis and treatment.However,when malignant biliary obstruction occurs,the anatomy of the bile duct has changed.Sometimes the guide wire cannot cross the narrow segment or enter the dilated bile duct,resulting in the failure of the operation.Through the problems,accidents and solutions in the ERCP treatment of a patient with pancreatic cancer and obstructive jaundice,this paper preliminarily explored the application of the guide wire of the nasobiliary drainage tube in the diagnosis and treatment of ERCP of malignant biliary obstruction with failed intubation.