What are the applications of ERCP guidewire in biliary tract injury?
Biliary diseases are frequently-occurring diseases. At present, operations such as open and laparoscopic cholecystectomy and common bile duct exploration are widely carried out in hospitals at all levels. The incidence of iatrogenic biliary tract injury increases, often causing biliary fistula and jaundice.
ERCP guidewire is a minimally invasive examination method, almost all biliary tract injuries can be clearly diagnosed, and most of them can be treated by endoscopy, avoiding the secondary operation of the abdomen, and the ERCP guidewire is clinically important. the value of.
Common causes of biliary injury:
1. Anatomical variation of extrahepatic bile duct;
2. Repeated episodes of chronic inflammation lead to adhesions;
3. Excessive stretch during surgery;
4. Bile duct burns;
5. Mis-clamping the bile duct;
6. Missed diagnosis of choledocholithiasis before operation, incarcerated choledocholithiasis after operation so that the internal pressure of the bile duct increases, causing the cystic duct stump ligature or titanium clip to fall off, etc.
The above causes of bile duct injury are difficult to completely avoid during surgery. Early diagnosis and treatment of biliary injury is very important. In the imaging examination, the endoscopic guidewire can not only accurately display the anatomical structure of the bile tree, but also take corresponding treatment measures in real time.
Should be the preferred means of inspection if possible. With the development of multidisciplinary combined treatment model in recent years, some researchers have proposed that endoscopic treatment should be the first choice in patients with bile duct injury as long as there is continuity between the biliary tract and the digestive tract.
Even if endoscopic treatment fails, it does not affect the efficacy of subsequent surgical treatment. However, if surgical repair is chosen rashly, changes in the structure of the digestive tract (Roux-en-y biliary-enteric anastomosis) will result in the patient no longer having the opportunity for endoscopic treatment.
According to the specific conditions of biliary tract injury, endoscopic (ERCP) treatment is performed by nasobiliary drainage, implantation of biliary stent, and columnar balloon dilation.
The ERCP guidewire is mainly used to treat biliary injury by reducing the pressure of the bile duct, diverting the bile at the bile duct fistula, sealing the fistula, dilating the stricture of the bile duct, and maintaining the smooth drainage of the bile duct.
Therefore, the application of ERCP guidewire in postoperative complications of biliary tract is both minimally invasive and effective, avoiding reoperation of the patient's abdomen, reducing medical expenses, and shortening the length of hospital stay. The ERCP guidewire is worthy of clinical promotion.
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