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2017 | 71 | 326-330
Article title

Ultrasonografia endoskopowa (EUS) w diagnostyce i leczeniu kamicy przewodów dróg żółciowych. Współczesna rola ECPW

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Title variants
EN
Endoscopic Ultrasonography (EUS) in Diagnostics and Treatment of Bile Duct Stones. The Current Role of ERCP
Languages of publication
PL EN
Abstracts
EN
Precise evaluation of the presence of bile duct stones, performed using the most non-invasive method, is important for the planning of optimal treatment. Not only simple imaging procedures (like conventional transabdominal ultrasound – US) but also more sophisticated imaging methods (CT or MRI) are frequently unreliable. The optimal method of bile duct stone non-invasive diagnostics is magnetic resonance cholangiography. The role of endoscopic retrograde cholangiopancreatography in diagnostics has receded into the background due to the possibility of numerous serious complications. Despite some limitations such as potentially increased treatment costs as well as the necessity of the procedure to be performed by a surgeon experienced in both endoscopic retrograde cholangiopancreatography as well as endoscopic ultrasonography, diagnostic endoscopic ultrasonography followed by simultaneous endoscopic retrograde cholangiopancreatography aimed at gallstone removal is the most efficient diagnostic and therapeutic management scheme in cases of suspected choledocholithiasis. The use of endoscopic ultrasonography allows one to limit the number of performed endoscopic retrograde cholangiopancreatography procedures by more than 2/3. Ascending endoscopic retrograde cholangiopancreatography combined with an endoscopic incision into the ampulla of Vater followed by mechanical evacuation of stone deposits from the ducts still remains a the optimal procedure in the treatment of choledocholithiasis.
PL
Precyzyjna diagnostyka obecności kamicy żółciowej przewodowej, przeprowadzona możliwie najmniej inwazyjnymi metodami, jest ważna przy podejmowaniu decyzji terapeutycznych. Nie tylko proste badania (jak konwencjonalna ultrasonografia – USG), ale też bardziej wyszukane metody obrazowania (tomografia komputerowa, rezonans magnetyczny) są często zawodne. Złotym standardem nieinwazyjnej diagnostyki kamicy przewodowej jest cholangiografia rezonansu magnetycznego – cholangio MRI. Rola cholangiopankreatografii wstecznej – ECPW w diagnostyce nieco przesunęła się na dalszy plan, ze względu na możliwość licznych istotnych powikłań. Pomimo pewnych wad, takich jak potencjalnie zwiększony koszt leczenia, konieczność wykonywania zabiegu przez lekarza doświadczonego zarówno w endoskopowej cholangiopankreatografii, jak i endoskopowej ultrasonografii, najbardziej efektywnym schematem postępowania diagnostyczno-terapeutycznego w przypadku podejrzenia kamicy przewodowej jest wykonanie diagnostycznej endoskopowej ultrasonografii z następową, jednoczasową endoskopową cholangiopankreatografią celem usunięcia złogów. Zastosowanie endoskopowej ultrasonografii pozwala ograniczyć liczbę wykonywanych endoskopowych cholangiopankreatografii o ponad 2/3. Endoskopowa cholangiopankreatografia wsteczna połączona z endoskopowym nacięciem zwieracza brodawki Vatera i mechaniczną ewakuacją złogów z przewodu nadal pozostaje złotym standardem w leczeniu kamicy przewodowej.
Discipline
Publisher

Year
Volume
71
Pages
326-330
Physical description
Contributors
  • Oddział Chorób Wewnętrznych, Pracownia Endoskopii, Samodzielny Publiczny Zespół Zakładów Opieki Zdrowotnej w Staszowie, kieltuckijacek@op.pl
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Document Type
article
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Identifiers
YADDA identifier
bwmeta1.element.psjd-0fa70229-237c-4d49-bd1f-7871531f0cb9
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