超声内镜引导下经口胆囊穿刺引流术入路选择的实验研究  

Experimental study of endoscopic ultrasonography-guided transoral gallbladder puncture and drainage

作　　者：王秀日 吕志武 吴建维[2] 郭玉庆 付娅[2] 胡翔[3] 屈卫翔 Xiu-ri Wang;Zhi-wu Lv;Jian-wei Wu;Yu-qing Guo;Ya Fu;Xiang Hu;Wei-xiang Qu(Second Clinical Medical College of Southern Medical University,Guangzhou,Guangdong 510515,China;Shenzhen Baoan Hospital Affiliated to Southern Medical University,Shenzhen,Guangdong 518101,China;Shiyan People's Hospital,Bao’an District,Shenzhen,Guangdong 518108,China)

机构地区：[1]南方医科大学第二临床医学院,广东广州510515 [2]南方医科大学附属深圳宝安医院,广东深圳518101 [3]深圳市宝安区石岩人民医院,广东深圳518108

出　　处：《中国现代医学杂志》2019年第24期22-26,共5页China Journal of Modern Medicine

基　　金：深圳市科技计划项目(No:JCYJ20160427192552523)

摘　　要：目的比较超声内镜引导下经胃窦和十二指肠球部胆囊穿刺引流术的操作难度、手术效果、术后并发症及后续胆汁对胃黏膜的影响。方法实验猪8头,将其分为经胃窦组和经十二指肠球部组,每组4头。在腹腔镜下实时观察超声内镜引导下经胃窦和十二指肠球部胆囊穿刺引流术,并于模型复制术后10 d处死实验动物,取吻合口及胃黏膜观察组织学改变。结果两组均有3头猪完全成功,两组操作成功率均为75%。经胃窦组平均操作时间短于经十二指肠球部组(21.67 min VS 26.67 min)(P<0.05),而胃黏膜损伤病理评分总分高于经十二指肠球部组(8.33分VS 6.33分)(P<0.05)。结论猪动物模型中,超声内镜引导下经十二指肠球部胆囊穿刺引流术操作难度稍大,但术后并发症少,较经胃窦胆囊穿刺引流术有优势。Objective To compare the operation difficulty,surgical effect,postoperative complications and the influence of bile on gastric mucosa of endoscopic ultrasonography-guided gallbladder drainage(EUS-GBD)through the gastric antrum and the duodenal bulb.Methods Eight pigs were divided into two groups,and 4 pigs in each group underwent EUS-GBD through the gastric antrum and the duodenal bulb under laparoscopy.The animals were sacrificed 10 days after successful modeling,and the anastomosis and gastric mucosa were observed for histological changes.Results Three pigs in each group were completely successful.The success rate of the two groups was 75%.The average operation time of the gastric antrum group(21.67 min)was shorter than that of the duodenum group(26.67min)(P<0.05),but the total pathological score of gastric mucosal injury(8.33 points)was higher than that of the duodenal bulb group(6.33 points)(P<0.05).Conclusions In the animal model of pigs,the endoscopic ultrasonography-guided gallbladder drainage through duodenal bulb is slightly more difficult and has less postoperative complications than through gastric antrum.

关 键 词：胆囊 穿刺术 腔内超声检查 动物 实验 幽门窦 支架 

分 类 号：R608[医药卫生—外科学]