■坏疽性胆囊炎是未经治疗的胆囊炎的严重并发症,需要立即干预。主要解决方法是胆囊切除术,手术切除胆囊。BillrothII胃切除术,以TheodorBillroth的名字命名,通过去除胃的一部分并将剩余部分重新连接到小肠来解决胃病。内镜逆行胰胆管造影术(ERCP)是诊断和治疗胆管和胰管疾病的微创手术,使用内窥镜进入管道,施用对比染料,并进行干预,如结石清除和支架放置。它有助于管理胆管结石等疾病,狭窄,胰腺肿瘤,和胰腺炎。
■一名25岁男性,有胃溃疡和BillrothII吻合术史,表现为右侧肋部疼痛,发烧,和呕吐。影像学检查提示胆囊水肿,脓肿,和流体收集。剖腹手术显示胆囊周围有严重粘连,被释放,脓肿被引流了.手术后,怀疑是胆瘘,导致ERCP程序的提议。ERCP期间,插入塑料支架以帮助胆汁引流。
■治疗性ERCP可有效治疗胆道渗出物,包括BillrothII胃切除术患者。使用侧视十二指肠镜简化了对Vater乳头的访问。这个成功的手术没有并发症,如胰腺炎或出血,患者保持稳定。
■ERCP在先前BillrothII胃切除术的患者中是一个具有潜在并发症的风险手术。然而,如果由具有必要设备的经验丰富的专家进行手术,则可以将其视为避免额外手术的替代方法。
UNASSIGNED: Gangrenous cholecystitis is a serious complication of untreated gallbladder inflammation, necessitating immediate intervention. The primary resolution involves cholecystectomy, the surgical removal of the gallbladder.The Billroth II gastrectomy, named after Theodor Billroth, addresses gastric conditions by removing a portion of the stomach and reconnecting the remaining section to the small intestine.Endoscopic retrograde cholangiopancreatography (ERCP) is a minimally invasive procedure that diagnoses and treats bile duct and pancreatic duct disorders, using an endoscope to access the ducts, administer contrast dye, and perform interventions like stone removal and stent placement. It aids in managing conditions such as bile duct stones, strictures, pancreatic tumors, and pancreatitis.
UNASSIGNED: A 25-year-old male with a history of gastric ulcer and Billroth II anastomosis presented with right hypochondrium pain, fever, and vomiting. Examination and imaging indicated gallbladder edema, abscess, and fluid collection. Laparotomy revealed severe adhesions around the gallbladder, which were released, and an abscess was drained. Postsurgery, a biliary fistula was suspected, leading to the proposal of an ERCP procedure. During ERCP, a plastic stent was inserted to aid bile drainage.
UNASSIGNED: Therapeutic ERCP effectively treats biliary exudate, including in patients with Billroth II gastrectomy. Using a side-viewing duodenoscope simplifies accessing Vater\'s papilla. This successful procedure had no complications, such as pancreatitis or bleeding, and the patient remained stable.
UNASSIGNED: ERCP in patients with a prior Billroth II gastrectomy is a risky procedure with potential complications. However, it can be considered as an alternative to avoid additional surgery if performed by experienced specialists with the necessary equipment.