{"id":546,"date":"2015-09-17T18:57:46","date_gmt":"2015-09-17T18:57:46","guid":{"rendered":"https:\/\/sred.ro\/?p=546"},"modified":"2021-11-18T19:01:29","modified_gmt":"2021-11-18T19:01:29","slug":"ercp-tehnica-rendez-vous-de-canulare-a-caii-biliare-folosind-abord-percutan-prin-tub-transcistic","status":"publish","type":"post","link":"https:\/\/sred.ro\/en\/ercp-tehnica-rendez-vous-de-canulare-a-caii-biliare-folosind-abord-percutan-prin-tub-transcistic\/","title":{"rendered":"ERCP: tehnica rendez-vous de canulare a caii biliare folosind abord percutan prin tub transcistic"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row][vc_column][vc_column_text]O pacienta de 63 ani a fost transferata in serviciul nostru cu suspiciunea de litiaza restanta de cale biliara principala la 3 zile de la colecistectomia laparoscopica efectuata intr-un alt spital. Colangiograma postoperatorie pe tub transcistic a evidentiat imagine sugestiva de calcul coledocian si pasaj ingreunat al contrastului in duoden (fig 1), pacienta prezentand circa 300-400ml drenaj biliar pe tubul transcistic in interval de 24 de ore. S-a decis efectuarea ERCP pentru extragerea calculului dar tentative repetate de canulare a caii biliare principale folosind tehnica cu sfincterotom si fir ghid au esuat. S-a practicat procedura rendez-vous, fiind avansat firul ghid biliar hidrofil de 0.0035 inchi anterograd prin tubul transcistic, sub control radiologic (fig 2), firul ghid fiind incarcat apoi retrograd pe sfincterotomul cu triplu lumen. Ulterior s-a canulat calea biliara principala, s-a schimbat firul ghid cu un fir montat anterograd pe sfincterotom (fig 3). S-a practicat sfincterotomie larga si s-au extras cateva fragmente de calcul folosind balonasul de extractie, cu drenaj convenabil al contrastului la finalul procedurii (fig 4-5). Postprocedural evolutia pacientei a fost favorabila, cu scaderea drenajului prin transcistic si suprimarea ulterioara a tubului de dren.[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_gallery type=&#8221;image_grid&#8221; images=&#8221;547,548,549,550&#8243;][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row][vc_column][vc_column_text]O pacienta de 63 ani a fost transferata in serviciul nostru cu suspiciunea de litiaza restanta de cale biliara principala la 3 zile de la colecistectomia laparoscopica efectuata intr-un alt spital. Colangiograma postoperatorie pe tub transcistic a evidentiat imagine sugestiva de calcul coledocian si pasaj ingreunat al contrastului in duoden (fig 1), pacienta prezentand circa [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":551,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[26],"tags":[],"class_list":["post-546","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cazul-lunii"],"featured_image_src":{"landsacpe":["https:\/\/sred.ro\/wp-content\/uploads\/2021\/11\/thumb_120_default_big-700x445.jpeg",700,445,true],"list":["https:\/\/sred.ro\/wp-content\/uploads\/2021\/11\/thumb_120_default_big-463x348.jpeg",463,348,true],"medium":["https:\/\/sred.ro\/wp-content\/uploads\/2021\/11\/thumb_120_default_big-291x300.jpeg",291,300,true],"full":["https:\/\/sred.ro\/wp-content\/uploads\/2021\/11\/thumb_120_default_big.jpeg",700,721,false]},"_links":{"self":[{"href":"https:\/\/sred.ro\/en\/wp-json\/wp\/v2\/posts\/546","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sred.ro\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/sred.ro\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/sred.ro\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/sred.ro\/en\/wp-json\/wp\/v2\/comments?post=546"}],"version-history":[{"count":1,"href":"https:\/\/sred.ro\/en\/wp-json\/wp\/v2\/posts\/546\/revisions"}],"predecessor-version":[{"id":552,"href":"https:\/\/sred.ro\/en\/wp-json\/wp\/v2\/posts\/546\/revisions\/552"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/sred.ro\/en\/wp-json\/wp\/v2\/media\/551"}],"wp:attachment":[{"href":"https:\/\/sred.ro\/en\/wp-json\/wp\/v2\/media?parent=546"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/sred.ro\/en\/wp-json\/wp\/v2\/categories?post=546"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/sred.ro\/en\/wp-json\/wp\/v2\/tags?post=546"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}