杨宁介入医学网

44 女性 胃癌，食管空肠RY吻合，放化疗。拒绝鼻饲管，持续性体重降低和消瘦。...

Patterns of BilateralStent Placement Y型 每个支撑架的功能是分别的，可以经过任何一个支撑架进行再干预治疗，需要双侧穿刺 T型 Only single side puncture easily accessible for reintervention...

PTBD stenting Self-expandable Covered vs. uncovered Length (4-8 cm.) diameter (8-10 mm.) Number of stents (1-3) Stent in stent?...

最大引流策略（Strategies to Maximise Drainage） 引流左侧还是右侧，还是双侧（Right or left or both?） Drain maximum liver volume with minimal catheters or stents 支撑架还是导管引流 Stent or catheter drainage 用内镜下的塑料支撑架或金属支架，...

Type I stricture 90% success Complications 15 -20% Survival mostly 3 months Type II or III strictures 20 -40% success Complications up to 55% Survival 4 -6 weeks...

Preprocedural work-up imaging 胆道扩张 Dilated bile ducts? 解剖变异 Anatomic variations? 阻塞水平/原因/阻塞范围 Level/cause/extension obstruction? 肝萎缩 Atrophy liver? 腹水 Ascites? 胆道是否扩张？ 可以通过超声或CT/MRI等影像学容易识别出来...

Learning Objectives Consider objectives of biliary drainage in malignant disease, with reference to pre surgical and palliative drainage Consider appropriate patient selection Consider how to optimize drainage in pre-surgical and palliativ...

这是首次胆道引流和支架的注册研究报告，目的是提供重要的结果数据，以指导目前的做法，这将为此类手术的操作者重新确认在未来方向。...

PTCD getting into troubleand out again Fever / sepsis Bleeding Catheter dislodgement Leakage...

在透视引导下，选择腋中线肋膈角下2~3cm为进针点。局部麻醉后（1%利多卡因，局部浸润麻醉）用细针（21G）穿刺进入肝脏。注意，穿此前在肋骨上缘用尖刀切开1~2mm破口，用蚊式钳进行皮下扩张。主要目的是可以稳定控制穿刺细针前行，不受皮肤阻力干扰；避免肋下...