Endoscopic biliary decompression

Endoscopic biliary decompression is performed by duodenal endoscopy, which is implanted into the appropriate part of the bile duct to achieve endoscopic treatment of bile drainage to the bile duct obstruction site or lesion site. Endoscopic nasobiliary drainage, biliary stent drainage. Older or other surgery is risky and unsuitable for surgery; it is not suitable for EST or endoscopic stone removal; prevention of stone incarceration or cholangitis can be used as preoperative preparation. Basic Information Specialist classification: Digestive examination classification: endoscope Applicable gender: whether men and women apply fasting: fasting Tips: Fast for 4-6 hours before check. Normal value After the operation, golden brown bile was taken out of the body, and the biliary obstruction was quickly relieved, the biliary pressure was lowered, and the drainage was smoothed, so that the patient's condition was quickly relieved and the infection was controlled. Clinical significance Abnormal results: no bile outflow. Need to check the crowd: 1. Obstructive jaundice patients before surgery to reduce yellow drainage; 2. Emergency decompression drainage of severe cholangitis and severe pancreatitis; 3. Flushing and drainage of patients with bile duct stones; 4. Older or other surgical risks, unsuitable for surgery; not suitable for EST or endoscopic stone removal; prevention of stone incarceration or cholangitis, can be used as preoperative preparation; 5. Benign biliary stricture. Can be used after endoscopic biliary dilatation, can also treat sclerosing cholangitis; 6. Timid. Precautions Contraindications before examination: fasting for 4 to 6 hours before examination. At the time of examination: If you have any discomfort, you should tell the doctor promptly and actively cooperate with the doctor's request. Inspection process Nasal bile duct drainage (ENBD) 1. Preoperative preparation: fasting for 4 to 6 hours, intramuscular injection of 50~100mg, 654--210mg, diazepam 10mg, and topical anesthesia with pharyngeal localized defoaming agent 10ml. 2. Operation method: After inserting the duodenoscope into the descending part and finding the sphincter nipple, the endoscopic cholangiography is performed first. After the obstruction site is determined, the guide wire is inserted into the bile duct above the obstruction, and the bile duct with the widest drainage range is selected. An elongated polyethylene nasal bile duct with an outer diameter of 6~8Fr is inserted into the guide wire, and the guide wire is taken out after reaching the predetermined part. The nasal bile duct is first taken out from the mouth, and finally a nasal catheter is taken out from the nostril and properly fixed. At the cheek, a sterile drainage bag is attached. 2. Biliary stent drainage (ERBD) First ERCP [retrograde cholangiopancreatography], to understand the location of the obstruction and the length of the stenosis, use the biliary tract to expand the stenosis under the guidance of the guide wire, select the appropriate internal drainage stent, and place the distal end in the duodenum In the outer ileum of the nipple, at the same time, in order to ensure the smoothness of the inner stent, it must be replaced in about three months. Not suitable for the crowd Unsuitable for the population: the hilar cholangiocarcinoma, the intrahepatic multi-stage bile duct invasion and drainage range is extremely limited, and should be used with caution. Adverse reactions and risks Nothing.

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