Healthy Hangzhou · experts are around
Experts of this issue
Chen Freeze
● Director and Deputy Chief Physician of the Department of Gastroenterology, Hangzhou Red Cross Hospital
Biography
He is good at the diagnosis and treatment of common, frequent and incurable diseases such as Helicobacter pylori infection, chronic atrophic gastritis, peptic ulcer, gastroesophageal reflux disease, functional gastrointestinal disease, gastrointestinal bleeding, pancreatitis, biliary tract and pancreatic diseases, proficient in colonoscopy, good at digestive endoscopy III and IV surgery, ESD, STER, EFTR, POEM, endoscopic ultrasound diagnosis and treatment of biliary and pancreatic diseases under EUS combined with ERCP technology.
Clinic hours
Wednesday morning, Friday afternoon (Renai Campus)
Tuesday afternoon (Qiantang Campus)
Highlights of this issue
The face was yellow, and the digestive endoscopic technique found out the "culprit".
What are the digestive endoscopy techniques?
What are the advantages of digestive endoscopy?
What diseases can be addressed by digestive endoscopy?
01
Transform into a "Minion"
Digestive endoscopy technology finds out the "culprit"
Aunt Zhang (pseudonym), who is in her 60s, is from Anhui Province and is usually in good health, has no underlying diseases, and works in the fields. But in the past week, I always feel that I have no strength, I can't exert my energy, and my face is very yellow.
The family took her to the local hospital for a blood test, and found that the bilirubin in the blood was significantly elevated and the liver function was damaged, so they drove to Hangzhou overnight and found Chen Lengyan, director of the gastroenterology department of the Hangzhou Red Cross Hospital.
After being admitted to the hospital, Aunt Zhang underwent abdominal CT and MRCP examinations, and pointed to the thickening and narrowing of the bile duct wall in the hilar part of the liver, which led to bile duct obstructive jaundice, and the possibility of tumor was not ruled out.
Image courtesy of the manuscript source
Chen Lengling's team discussed MDT and decided to perform ERCP cholangioscopy + bile duct wall biopsy + bile duct stenting. The operation went smoothly, and the jaundice decreased significantly after surgery.
The pathological results showed: adenocarcinoma! The rapid diagnosis of digestive endoscopy technology bought valuable time for Aunt Zhang's follow-up treatment.
02
The doctor's "clairvoyant eye"
Digestive endoscopy technology allows the lesion to have nowhere to hide
Digestive endoscopy is a diagnostic and ultra-minimally invasive treatment technology developed on the basis of gastroscopy and colonoscopy, such as ERCP, EUS, ESD and so on. Endoscopy can make the lesion invisible and solve the problem through endoscopy-related treatment techniques.
The biliary and pancreatic system of the human body is a very complex pipe system, how to check and dredge it? Endoscopic retrograde cholangiopancreatography (ERCP) is a very important procedure.
The doctor inserts the duodenoscopy into the descending duodenum, finds the duodenal papilla, inserts the contrast catheter from the biopsy tube to the opening of the nipple, injects the contrast agent and takes an X-ray to clearly see the complex tubes of the pancreaticobiliary duct from the picture.
Image courtesy of the manuscript source
With the advancement of science and technology, imaging technology is changing with each passing day, the diameter of endoscopes is getting thinner and thinner, and biliary sub-motherscopes come into being. "Mirror-in-mirror", that is, a smaller mirror is inserted through the duodenoscopic instrument channel, so as to penetrate deep into the biliary tract and even the pancreatic duct, providing clear images, allowing the doctor's field of vision to enter the previously inaccessible cavities, thus helping to diagnose the possibility of duct disease.
ERCP is operated through the natural orifice of the human body, which is less invasive and faster than traditional surgery. During the procedure, the duodenal papillae can be directly observed and biopsied, which has diagnostic value for some obstructive jaundice. Bilateral biliary drainage and multi-branch bile duct drainage can be performed intraoperatively without significantly increasing trauma, and the effect is significant.
03
These diseases
Digestive endoscopy "E" can be used and resolved
In addition to the examination and diagnosis of biliary and pancreatic diseases, ERCP also plays an irreplaceable role in the treatment of biliary and pancreatic diseases!
The picture is from the copyright gallery, please do not reprint
01
Common bile duct stones
ERCP allows stones to be easily removed from the intestines, i.e. "stone removal from the mouth".
02
Acute obstructive purulent cholangitis
Nasal bile duct drainage and stent placement effectively drain infected bile and rapidly reduce bile duct pressure.
03
Acute biliary pancreatitis
Especially for severe biliary pancreatitis, timely drainage of bile can significantly reduce mortality.
4
Yellowing of advanced periampullary cancer
Drain bile, relieve jaundice, and improve quality of life.
- Contributed by Hangzhou Red Cross Hospital
- Please indicate "Healthy Hangzhou"
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