Central South University Xiangya Second Hospital's gallbladder pancreatic surgery uses endoscopic technology to successfully treat acute pancreatitis pregnant women

Recently, the biliary pancreatic surgery of Xiangya Second Hospital of Central South University successfully performed an ERCP surgery for patients with patients with acute pancreatitis and acute cholangitis. After surgery, patients quickly recovered.

It is reported that acute pancreatitis is one of the clinical acute abdomen. It often causes urgency, progress is fast, and it is easy to develop into severe illness and threatened the life of patients. If acute pancreatitis occurs during pregnancy, it will greatly increase the risk and treatment of the disease, and the condition will bring great threat to the mother and the fetus. For acute pancreatitis caused by gallstones, bile duct drainage (ERCP) under duodenoscopy is the most minimally invasive and effective treatment method, but ERCP requires the guidance of X -ray. The risk of abnormality and even abortion became one of the difficulties in clinical treatment.

Ms. Chen was 40 years old, 36 weeks of pregnancy, and had a history of gallbladder stones for 7-8 years. Due to the "upper abdominal pain with the skin scleral yellow dyeing for 4 days" to the outer hospital, after the inspection, the B -ultrasound showed the bile duct expansion and the gallbladder was diverse. Biochemical examination total bilirubin 89.8umol/L (normal value <17.1umol/L), serum amylase 2433U/L (normal value <53U/L). The foreign hospital considers secondary bile duct and acute pancreatitis, which requires surgical treatment. Because of Ms. Chen's pregnancy in the palace and merging pregnancy diabetes, her condition was complicated, so she moved to Xiangya Second Hospital of Central South University on the evening of September 16.

After consulting Ms. Chen, the chief physician of the gallbladder and pancreas surgery, reported the case of Liu Wei, the director of the case department, and contacted the obstetrics consultation to evaluate the fetal condition. After discussion, combined with the history of Ms. Chen's gallbladder stones and various examination results, it was considered to be discharged into the gallbladder stones into the gallbladder chief, causing gallbladder to block and cause acute biliary pancreatitis. Considering the special circumstances of the patient's pregnancy, the team decided to perform an ERCP surgery without X -ray on the basis of previous experience.

Before surgery, the medical staff gave Ms. Chen fully soothe and psychological comfort, only anesthesia in the throat, be careful to enter the duodenoscope, try to give her the smallest stimulus, the mirror body reaches the duodenum downside, and find the twelve. Refers to large intestine nipples. After inserting the nipple cut, the direction is adjusted. The guide wire is successfully entered. With the X -free guidance, push the cutting sword a little, get bile after pumping, and then gently follow the cutting and the swing. , Confirmed that successfully entered the bile duct, choose the appropriate bile duct bracket according to experience. Under the guidance of X -rays, relying on the experience and judgment of the operator, the successful coating of the bile tract plastic stent, which shows that the bile and sediment stones are from the bracket and the stent and The nipple overflowing, achieved surgical purposes, and successfully completed the surgical operation. The entire surgical process took only 10 minutes. Ms. Chen avoided the risks brought by X -rays and anesthesia drugs.

On the second day after surgery, Ms. Chen's abdominal pain symptoms were completely relieved. Reviewing the total bilirubin was basically normal, and blood amylase and leukocytes also dropped rapidly, and she slowly resumed her diet. On the third day of the operation, Ms. Chen and the fetus were in good condition. , Smoothly discharged.

Director Liu Wei said that the gallbladder stones were often onset of common diseases, and some patients did not pay attention. Gallbladder stones can cause acute purulent cholecystitis and severe biliary perforation; gallbladder stones into the biliary tube can cause cholangitis and pancreatitis, which can cause severe consequences, especially in pregnancy, various factors have caused bile empty to be affected, and more It is prone to acute cholecystitis, bile tubeitis and pancreatitis caused by gallstones, which seriously threaten the safety of pregnant women and fetuses. Here, once you find gallbladder stones, you must go to the hepatobiliary and pancreas surgery for consultation and listen to the advice of doctors.

Since the establishment of the biliary pancreatic surgery of Xiangya Second Hospital of Central South University, while developing traditional surgical treatment, it has vigorously developed minimally invasive technologies such as gallbladder pancreatic endoscopy, forming a biliary pancreatic minimally invasive diagnosis and treatment system based on bile pancreatic endoscopy, so that The diagnosis and treatment of many gallbladling diseases truly achieve minimally invasive or even non -invasive, especially in the treatment of some patients with severe severe patients, and can relieve patients' illness with the minimum trauma. This case was successfully treated through the ERCP without X -free, which not only received the fastest recovery, but also avoided the impact of trauma and rays on the fetus, so that patients could wait for the fetus in the best state. This case reflects the advantages of endoscopy to the fullest, and also reflects the good technical and talent reserves of biliary and pancreas, as well as the team's lean to solve clinical problems.

Manuscript Source: Xiangya Second Hospital of Central South University

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