Terapötik endoskopik retrograd kolanjiografide V-Skop sisteminin avantajları

Giriş ve Amaç: Endoskopik retrograd kolanjiografide, bazen çok deneyimli ellerde dahi, hızlı ve güvenli bilier kanülasyon, terapötik işlem uygulamaları bir problem haline gelebilir. V-sistem değiştirilmiş bir duodenoskop tipi olup işlemi kolaylaştırmak ve geliştirmek, endoskopik retrograd kolanjiografi süresini kısaltmak üzere üretilmiştir. Bu çalışmanın amacı V-sistemin avantajlarını değerlendirmek ve konvansiyonel duodenoskop ile karşılaştırmaktır. Gereç ve Yöntem: Ocak/2011 boyunca endoskopik retrograd kolanjiografi için başvuran tüm hastalar bu çalışma için değerlendirildi. V- sistem veya konvansiyonel duodenoskop randomize olarak seçildi. İşlem ile ilgili tüm parametreler kronometre kullanılarak kaydedildi. Bulgular: Çalışamaya 63 hasta dahil edildi, bunların 36'sı V-sistem grubunda, 27'si ise konvansiyonel duodenoskopi grubunda idi. Gruplarda en sık tanı kolelitiazis olup en sık işlem ise bilier stent yerleştirilmesi idi. Hem total işlem süresi hem de floroskopi süresi V-sistem grubunda belirgin kısa idi. Kılavuz tel kaybı ve kılavuz tele yeniden pozisyon verme ihtiyacı V-sistem grubunda açık olarak daha az idi. Sonuç: V-sistem kılavuz tel kontrolünde ve işlem süresinde avantajlar göstermektedir, bu durum endoskopik retrograd kolanjiografi işlemlerini uygulamada ikna edici faydalar sağlamaktadır.

Advantages of V-scope system in therapeutic endoscopic retrograde cholangiography

Background and Aims: Fast and reliable biliary cannulation and therapeutic attempts can be problematic in endoscopic retrograde cholangiography, even in experienced hands. The V-system is a modified duodenoscope design, and was developed in order to simplify and improve the procedure and shorten the length of endoscopic retrograde cholangiography. The aim of this study was to evaluate the V-system advantages and compare the V-system with conventional duodenoscope. Materials and Methods: All patients admitted for biliary endoscopic retrograde cholangiography throughout January 2011 were assessed for the study. Patients were assigned to the V-system or conventional duodenoscope groups randomly. All parameters about the procedure were recorded by a chronometer. Results: Sixty-three patients were included, with 36 in the V-system group and 27 in the conventional duodenoscopy group. The most common diagnosis in the groups was cholelithiasis, and the most common attempt was implantation of biliary stent. Both total procedure time and fluoroscopy time were significantly shorter in the V-system group than conventional duodenoscope group. Loss of guide wire and necessity of guide wire repositioning occurred clearly less often in the V-system group. Conclusions: The V-system has shown some advantages in guide-wire control and procedure length, and provides convincing benefits in the performance of endoscopic retrograde cholangiography procedures.

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