The common bile duct stent is placed through the PTCD channel, which is suitable for conditions such as duodenal stenosis and intestinal diversion that cannot be performed after ERCP. It can replace PTCD tubes, so as to improve life and avoid the inconvenience caused by PTCD tubes and drainage bags.
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50 years oldPancreatic cancer patientsCompression of the common bile duct causes obstructive jaundice with ascites. patientsIn the past, the PTCD tube was blocked, and the yellowing effect was poor, come to my department**.
We'll see you under the X-lineThe original PTCD tube was twisted and discounted, so there was a blockage
After entering the guidewire from the original PTCD tube, slowly pull out the original PTCD tube outward, alongsideThe guidewire is implanted into a new PTCD tube。A guidewire was introduced, and iohexol imaging was used to detect the obstruction of the lower end of the common bile duct and the dilation of the common bile duct. We are alongNew PTCD tubesPlace the guidewire and withdraw the new PTCD tubeInsert the expansion bougie along the guidewire, adjust the direction so that the guidewire passes through the bile duct stricture into the duodenum and dilates the bougieFollow the guidewire into the duodenum, confirmed by angiography. Withdraw the dilated bougie along the guidewireA metal stent for the common bile duct is placedSupport dilates the stenosis of the lower end of the common bile duct, so that the bile smoothly enters the duodenum and relieves the common bile duct obstruction.
Bile enters the intestine to aid digestion and avoid bile loss, and patients no longer need to carry PTCD tubes and drainage bags, which improves their lives.
Figure 1: Placement of a metal stent for the common bile duct** through the PTCD channel for malignant obstructive jaundice.
Place a common bile duct stent through the PTCD channel, suitable for:ERCP cannot be performed after duodenal stenosis and intestinal diversionsituation. YesReplace PTCD tubes, thus improving livesAvoid the inconvenience caused by PTCD tubes and drainage bags
Someone will ask,What if the guidewire doesn't go smoothly into the duodenum? Isn't it impossible to place a biliary stent?
If the guidewire doesn't go smoothly into the duodenum, we still haveultra-fine cholangioscope, etc**, which can guide the guidewire smoothly into the duodenum.
What if all of the above fails?
We still havelaparoscopic surgery and other meansJaundice can be relieved.
Hepatobiliary surgeons have a comprehensive grasp of various comprehensive techniques such as endoscopy and ultrasound-guided puncture, so that they can take individualized ** according to the different conditions of patients, strive for excellence, and achieve the best results with the least trauma to serve patients.
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