内镜逆行阑尾炎治疗：一种初步的微创技术(带视频)

Liu, B.-R.; Digestive Endoscopy Center, Department of Gastroenterology and Hepatology, Second Affiliated Hospital of Harbin Medical University, 246 Xue-Fu Road, Nan-Gang District, Harbin 150086, China

Background: Inspired by the success of ERCP for the treatment of suppurative cholangitis, we investigated a new minimally invasive method for the treatment of acute uncomplicated appendicitis, which we call endoscopic retrograde appendicitis therapy. Objective: To investigate the feasibility and efficacy of endoscopic retrograde appendicitis therapy for the treatment of acute uncomplicated appendicitis. Design and Setting: A retrospective, single-center study at an academic medical center. Patients: Four patients with acute uncomplicated appendicitis. Interventions: There were 5 steps after insertion of a colonoscope into the cecum and identification of the appendiceal orifice: (1) endoscopic appendiceal intubation; (2) appendiceal decompression; (3) retrograde appendicography; (4) stent drainage; and (5) cleansing the appendiceal lumen. Main Outcome Measurements: The rate of successful endoscopic intubation and decompression, the time to symptom relief, the time to disappearance of signs, increased white blood cell count, procedure-related complications, and recurrence, if any. Results: All 4 endoscopic appendiceal intubations were successful. Pain was relieved immediately after endoscopic decompression and stent drainage. Leukocytosis returned to normal within 24 hours. There were no complications and no recurrences during 4 to 19 months of follow-up. Limitations: Small sample size, single-center study without controls. Conclusion: Endoscopic retrograde appendicitis therapy is a feasible and effective endoscopic treatment modality for acute uncomplicated appendicitis. © 2012 American Society for Gastrointestinal Endoscopy.

Digestive Endoscopy Center, Department of Gastroenterology and Hepatology, Second Affiliated Hospital of Harbin Medical University, 246 Xue-Fu Road, Nan-Gang District, Harbin 150086, China