内镜逆行胰胆管造影联合经口子母胆道镜治疗胆总管结石合并胆囊颈部结石及胆囊息肉1例报告

陶丽莹; 王宏光; 郭庆梅; 杜迎亭; 朴连玉; 刘敬; 姜峰

doi:10.3969/j.issn.1001-5256.2023.05.024

内镜逆行胰胆管造影联合经口子母胆道镜治疗胆总管结石合并胆囊颈部结石及胆囊息肉1例报告

DOI: 10.3969/j.issn.1001-5256.2023.05.024

吉林市人民医院消化内镜中心，吉林吉林 132001

基金项目:

吉林市医疗卫生指导性计划项目 (20210409008);

吉林省卫生健康科技能力提升项目 (2021LC120)

伦理学声明：本例报告已获得患者知情同意。

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：陶丽莹负责课题设计，资料分析，撰写论文；郭庆梅、朴连玉、刘敬、姜峰参与手术操作，收集数据，修改论文；杜迎亭提供病理支持；王宏光负责拟定写作思路，指导撰写文章并最后定稿。

详细信息

通信作者:
王宏光, wanghongguang1817@163.com (ORCID: 0000-0003-1100-9804)

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出版历程
- 收稿日期: 2022-08-29
- 出版日期: 2023-05-20

Endoscopic retrograde cholangiopancreatography combined with peroral choledochoscopy in treatment of common bile duct stones with gallbladder neck stones and gallbladder polyps: A case report

Department of Digestive Endoscopy Center, Jilin People's Hospital, Jilin, Jilin 132001, China

Research funding:

Jilin City Medical and Health Guidance Plan Project (20210409008);

Jilin Province Health Science and Technology Capacity Improvement Project (2021LC120)

More Information

Corresponding author: WANG Hongguang, wanghongguang1817@163.com (ORCID: 0000-0003-1100-9804)

摘要

- 胆总管结石病 /
- 胆囊结石病 /
- 息肉 /
- 胰胆管造影术, 内窥镜逆行 /
- 经口子母胆道镜
- Choledocholithiasis /
- Cholecystolithiasis /
- Polyps /
- Cholangiopancreatography, Endoscopic Retrograde /
- Peroral Choledochoscopy

HTML全文

图 1 MRCP影像(2022年8月10日)

注：a，胆总管下段腔内可见多个直径6 mm以下小圆形低信号充盈缺损影(白色圆圈)，其上方胆总管扩张，最宽约达13 mm。胆囊体积不大，壁厚，其内可见小类圆形短T2信号充盈缺损影；胆囊管低位汇合，胆囊颈部可见多发小圆形低信号充盈缺损影(红色箭头)；b，胆囊壁增厚，呈双层结构(黄色箭头)。

Figure 1. MRCP image (August 10, 2022)

下载: 全尺寸图片幻灯片

图 2 EUS影像(2022年8月11日)

注：a，胆囊颈部可见强回声光团，后伴声影(红色箭头)，可见其上方并行的扩张胆总管(蓝色箭头)；b，胆总管下段可见多发强回声光团，后伴声影(黄色圆圈)。

Figure 2. EUS image (August 11, 2022)

下载: 全尺寸图片幻灯片

图 3 ERCP联合eyeMax经口子母胆道镜治疗过程(2022年8月11日)

注：a，常规ERCP行胆总管结石网篮取石；b，eyeMax经口子母胆道镜进入胆道内，直视找到胆囊管开口，沿着导丝进入胆囊颈管；c，eyeMax经口子母胆道镜进入胆囊颈部可见胆囊颈部结石(黄色虚线内)；d，应用经口子母胆道镜的子母网篮套取胆囊颈部结石，将其拖拽至肠道；e，再次进入eyeMax经口子母胆道镜，可见胆囊颈部螺旋状结构；f，进入胆囊腔内，应用甲硝唑溶液冲洗后可见胆囊壁网格状结构，并清晰可见息肉样病变，略呈黄色(红色箭头)；g，将子母热活检钳通过子母胆道镜工作孔道进入胆囊腔内，直视下钳取息肉样隆起；h，直视下电凝切除息肉样隆起，可见切除后的创面(蓝色箭头)；i，术后留置鼻胆囊引流管，X线示鼻胆管位置良好。

Figure 3. ERCP combined with eyeMax via oral choledochoscopy (August 11, 2022)

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图 4 病理检查结果

注：a，HE染色(×20)；b，HE染色(×40)。

Figure 4. Pathological HE staining results

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