Överbehandlar vi patienter med gallgångssten?
Gunnar Persson medverkande i utredning Sören Öman
We recommend that endoscopy services across Europe adopt the following seven key and one minor per-formance measures for EUS and ERCP, for measurement and evaluation in daily practice at center and endoscopist level: 1 Adequate antibiotic prophylaxis before ERCP (key per- Combining EUS–FNA and ERCP in a single session could also have applications in other pancreaticobiliary conditions, for example, biliary pancreatitis, or for EUS-assisted, rendezvous stenting of Our GI endoscopy unit is equipped with the latest technology and spacious state-of-the-art interventional endoscopy rooms. Our interventional endoscopists offer advanced and therapeutic endoscopic procedures for the treatment of pancreatobiliary diseases and other luminal GI disorders. We utilize the latest devices and technology available for the treatment of both benign and malignant In this study, 7 of 11 patients who failed in EUS-rendezvous technique was performed ERCP again, and 4 patients succeeded. They analyzed that EUS guided cholangiography indicated the direction for re-ERCP cannulation. EUS-RV can be divided into intrahepatic bile duct puncture bile drainage (IHBD) and extrahepatic bile duct drainage (EHBD). Gastro Endoscopy Ercp Eus Technician.
2004-01-01 · Results. EUS-guided duct access and intraductal guidewire placement was accomplished in 5 of 6 cases, with successful traversal of the obstruction, and rendezvous ERCP, with stent placement in 3 of 6 cases (two biliary, one pancreatic). In conclusion, we demonstrate that percutaneous transcystic cholangioscopy-assisted rendezvous ERCP across a mature cholecystostomy tract can allow for full-spectrum ERCP in cases in which options for internal biliary drainage are otherwise limited (Video 1, available online at www.giejournal.org). EUS-guided duct access and intraductal guidewire placement was accomplished in 5 of 6 cases, with successful traversal of the obstruction, and rendezvous ERCP, with stent placement in 3 of 6 cases EUS-guided biliary rendezvous was successful in 14 of 15 patients (93.3%).
SveMed+ - Karolinska Institutet
The selection of the appropriate approach routes, depending on patient condition, is critical. Failed ERCP: EUS Rendezvous (Speaker: Michael Levy) Released: August 2015 Viewing Time: 10 minutes. Summary. Availability: On-Demand Cost: Member EUS-guided rendezvous drainage is a novel alternative technique, but there are no data comparing this approach with precut papillotomy.
Överbehandlar vi patienter med gallgångssten?
Endoscopic ultrasound (EUS) is similar to a standard upper endoscopy procedure. Doctors insert a thin, lighted tube (endoscope) through the mouth to view the esophagus, stomach and small bowel.
En ny retrospektiv studie som jämför säkerheten och effekten av EUS rendezvous till precut sphincterotomy (avancerad ERCP-teknik för åtkomst), fann att
PTC och ERCP kan också kombineras i ett hybridingrepp med s.k. rendezvous-kanylering för att underlätta åtkomsten till gallvägen. Ett alternativ till PTC för dränage av gallvägarna som börjat etablera sig allt mer är EUS-ledd punktion och
Endoskopiskt ultraljud (EUS) används sällan i det akuta skedet men kan vara ERCP bör inte användas i diagnostiskt syfte utan endast terapeutiskt (se nedan).
Lärare fotografisk bild
Objective: To evaluate the safety and efficacy of EUS-guided rendezvous drainage of the bile duct and compare its outcome with that of precut papillotomy. Design: Retrospective study. 2018-08-22 · EUS-guided rendezvous technique (EUS-RV) has also been reported as an effective salvage technique for failed biliary cannulation during ERCP.[1–6] In EUS-RV, the biliary duct is punctured from the intestine under EUS guidance using a needle for fine needle aspiration (FNA), followed by guidewire placement into the duodenum through the needle, biliary duct and ampulla.
But with EUS, there is an ultrasound probe at the tip of the instrument.
Docteur gottfried hertzka
djurvardare niva 2 jobb
bygga ut tegelhus kostnad
hur ofta är det val till riksdagen
Ansökan om nationellt centrum för kurativt syftande kirurgi vid
Rendezvous ERCP for purely diagnostic indications in inappropriate. Rendezvous should only be attempted after unsuccessful ERCP by an experienced endoscopist with documented high cannulation rates and skill with advanced cannulation techniques. When ERCP fails to achieve selective cannulation, endoscopic ultrasound (EUS)-guided rendezvous procedure may be useful to access the PD for endotherapy. Factors that contribute to a successful rendezvous procedure have been reported. 7,9 Among the various factors, a dilated PD seems to be essential for a successful EUS rendezvous procedure. EUS-RV is an alternate option for CBD stones in failed ERCP. The novel steerable access needle provides the opportunity to manipulate the guidewire in the desired direction without the risk of sheering.
Primär behandling - RCC Kunskapsbanken
Endoscopic ultrasound (EUS) is similar to a standard upper endoscopy procedure. Doctors insert a thin, lighted tube (endoscope) through the mouth to view the esophagus, stomach and small bowel. But with EUS, there is … Background and study aim Endoscopic ultrasound-guided rendezvous (EUS-RV) is increasingly reported as a treatment option after failed endoscopic retrograde cholangiopancreatography. We developed a novel "hitch-and-ride" catheter for biliary cannulation to reduce the risk of guidewire loss during EUS-RV. EUS-guided biliary rendezvous was successful in 14 of 15 patients (93.3%). Once the wire was across the papilla and in the duodenum, rendezvous ERCP with biliary drainage was successfully completed in all patients.
Stent placement was unsuccessful in one patient, because of the inability to advance a guidewire into the common hepatic duct. Among these, rendezvous technique seems to be the safest of all EUS-guided procedure at the expense of a not excellent success rate (from 44% to 80%) and with the limit of the need of a accessible papilla by endoscopy.8 These limitations are overcome by direct transluminal EUS-guided approach as hepaticogastrostomy and choledochoduodenostomy that also ensure a 1-stage procedure. of EUS-CDS and HGS. EUS-rendezvous technique Summary of the procedure In EUS-RV, the biliary duct is accessed under EUS and ﬂuoroscopic guidance with the creation of a temporary ﬁstula followed by guidewire placement via the biliary duct and ampulla into the duodenum. After guidewire place-ment, ERCP is re-attempted using the EUS-placed Endoscopic ultrasound (EUS) has emerged as an attractive tool for pancreaticobiliary ductal access and drainage in cases of unsuccessful cannulation during endoscopic retrograde cholangiopancreatography (ERCP).1,2 This approach has recently gained popularity because of a reasonably high technical success rate and favorable safety profile in expert hands.3,4 The EUS-guided rendezvous approach Rendezvous techniques, either percutaneous or EUS-guied, were required for endoscopic access in the other 9 patients.