EyeMax洞察胆胰管成像系统辅助内镜逆行阑尾炎治疗术的疗效及安全性分析

Efficacy and safety analysis of eyeMax insight cholangiopancreatography system assisted ERAT

摘要:

目的 探究一次性eyeMax洞察胰胆管成像系统辅助内镜逆行阑尾炎治疗术（ERAT）治疗阑尾炎的效果及安全性。方法 回顾性分析2023年4月－2024年9月在该院就诊，通过影像学或内镜检查确诊的54例非复杂性阑尾炎患者的临床资料。所有患者均行eyeMax洞察胆胰管成像系统辅助ERAT，于直视下观察阑尾腔，并通过冲洗、取石、扩张狭窄和支架引流等措施治疗阑尾炎。观察手术相关指标、术后疼痛程度、并发症发生情况、术后1年内复发率、结肠镜下表现、胰胆管成像系统下表现和胆胰管成像系统下治疗情况。结果 54例患者均顺利完成手术，技术成功率为100.0%，手术时间（60.6±27.9）min，住院时间（3.6±1.5）d；30例（55.6%）阑尾开口及周边黏膜充血水肿，2例（3.7%）可见脓液及污秽物流出；54例（100.0%）患者阑尾腔内壁充血水肿，51例（94.4%）可见腔内絮状物、脓液或脓苔附着，25例（46.3%）可见腔内粪石，15例（27.8%）可见管腔走形迂曲或狭窄。所有患者予以eyeMax洞察胰胆管成像系统治疗，简单灌洗54例，网篮取石20例，支架引流25例。术后VAS评分为0（0，0）分，明显低于术前的6（3，7）分，手术前后比较，差异有统计学意义（Z = -6.24，P = 0.000）。所有患者术后症状均暂时缓解，术中及术后未发生穿孔和大出血等严重不良事件。随访1年内，阑尾炎复发率为20.4%（11/54）。结论 EyeMax洞察胆胰管成像系统辅助ERAT是治疗非复杂性阑尾炎安全和有效的疗法，其具有直视下精准操作、保留阑尾功能、症状快速缓解、无X线暴露和精准诊疗阑尾病变等优势。值得应用于临床。

Abstract:

Objective To explore the efficacy and safety of one-time eyeMax insight cholangiopancreatography system assisted endoscopic retrograde appendicitis therapy (ERAT) in appendicitis.Methods A retrospective analysis was conducted on the clinical data of 54 patients with uncomplicated appendicitis who were diagnosed through imaging or endoscopic examinations from April 2023 to September 2024. All patients underwent ERAT assisted by eyeMax insight cholangiopancreatography system to observe the appendiceal cavity under direct vision. Appendicitis was treated through measures such as irrigation, stone removal, dilation of stenosis and stent drainage. Observe the surgery-related indicators, the degree of postoperative pain, the occurrence of complications, the recurrence rate within one year after the operation, the manifestations under colonoscopy, the manifestations under the pancreaticobiliary imaging system and the treatment under the biliary and pancreatic duct imaging system.Results All 54 patients successfully underwent the procedure, the technical success rate was 100.0%, with a mean operative time of (60.6 ± 27.9) minutes and an average length of hospital stay of (3.6 ± 1.5) days. In 30 cases (55.6%), the opening of the appendix and the surrounding mucosa were congested and edematous, and in 2 cases (3.7%), pus and impurities could be seen flowing out. The inner walls of the appendiceal lumen of 54 cases (100.0%) were congested and edematous. Flocculent substances, pus or pus coating attached to the lumen could be seen in 51 cases (94.4%), fecalith in the lumen could be seen in 25 cases (46.3%), and the lumen was tortuous or narrowed in 15 cases (27.8%). All patients were treated with eyeMax insight cholangiopancreatography system. Simple lavage was performed in 54 cases, stone removal in a net basket in 20 cases, and stent drainage in 25 cases. The postoperative VAS score was 0 (0, 0) points, which was significantly lower than 6 (3,7) points before the operation. A comparison before and after the operation showed a statistically significant difference (Z = -6.24, P = 0.000). All patients' symptoms were temporarily relieved after the operation, and no serious adverse events such as perforation and massive hemorrhage occurred during or after the operation. Within one year of follow-up, the recurrence rate of appendicitis was 20.4% (11/54).Conclusion EyeMax insight cholangiopancreatography system assisted ERAT is a safe and effective therapy for uncomplicated appendicitis. It has the advantages of precise operation under direct vision, preservation of appendix function, rapid symptom relief, no X-ray exposure, and precise diagnosis and treatment of appendiceal lesions. It is worth applying in clinical practice.