Drainage ºÐ·ù
1.Hepatobiliary
Percutaneous Transhepatic Biliary Drainage:°æÇÇ°æ°£ ´ãÁó¹è¾×¼ú
Percutaneous Abscess Catheter Drainage:°æÇÇÀû ³ó¾ç ¹è¾×¼ú
PTBD tube change:´ãÁó ¹è¾×°ü ±³È¯¼ú
Percutaneous Cholecystostomy:°æÇÇÀû ´ã³¶¾× ¹è¾×¼ú
Bile duct dilatation: ´ã°ü È®Àå¼ú
Biliary stent placement:´ã°ü ½ºÅÙÆ® ¼³Ä¡¼ú
2.Non-Biliary
Percutaneous Nephrostomy:°æÇÇÀû ½Å·ç ¼³Ä¡¼ú
Ureteral stent placement:¿ä°ü ½ºÅÙÆ® ¼³Ä¡¼ú
Pancreatic Abscess:ÃéÀå ³ó¾ç ¹è¾×¼ú
Lung Abscess:Æó ³ó¾ç ¹è¾×¼ú
°£ÀÇ ±â´É
º¹°¿ìÃø »óºÎ¿¡ À§Ä¡ÇÑ ÀÎü¿¡¼ °¡Àå Å« Àå±â
°£µ¿¸Æ¹× ¹®¸ÆÀ¸·ÎºÎÅÍ ÀÌÁßÀÇ Ç÷¾×°ø±ÞÀ» ¹Þ´Â´Ù
¿ì¿±°ú Á¿±À¸·Î ³ª´²Áö¸ç ¿ì¿±ÀÌ ´õ Å©´Ù.
±â´É: 1.ºÐºñ¹èÃâ ±â´É(´ãÁó »ý¼º)
2.´çºÐ ÀúÀå ¹× Ç÷´ç Á¶Àý±â´É
3.Á¶Ç÷ ¹× Ç÷¾×ÀÀ°í °ü¿©(Heparin »ý¼º)
4.Çص¶ÀÛ¿ë
5.steroid ´ë»ç¿¡ °ü¿©
Anatomy
Anatomy
Bile Flow Route
IHD(Intrahepatic Du¡¦(»ý·«)
|
F)/Drainage cath
Drain Fixation/Bile bag
PTBD Approach
°æÇÇÀû ´ã³¶¾× ¹è¾×¼ú-PTGBD
´ã³¶(Gallbladder): °£¿¡¼ »ý¼ºµÈ ´ãÁóÀ» ÀúÀå ¹×
³óÃàÇÏ´Â Àå¼Ò
´ã³¶°üÀÌ Æó¼âµÇ¾î ÀÚ¿¬ ¹è¾×¿¡ ¹®Á¦ ¹ß»ý½Ã ¹è¾×°üÀ» »ðÀÔÇÏ¿© ÀϽÃÀûÀ¸·Î ü¿Ü·Î ¹è¾×½ÃÅ°´Â ½Ã¼ú
-±Þ¼º ´ã³¶¿°(acute cholecystitis)
-ÃѼö´ã°üÀÇ Æó¼â(CBD obstruction)
-´ã³¶°á¼®ÀÇ Ä¡·á¸¦ À§ÇÑ °æ·Î È®º¸
»ç¿ë¹°Ç°:Puncture needle/.035 G/W/
Dilator(6-8F)/Drainage cath(6-8F)
Anatomy
´ã°ü È®Àå¼ú-Bile duct dilatation
´ã°üÀÇ ÀϺΰ¡ ÇùÂøµÈ °æ¿ì PTBD Åë·Î¸¦ ÅëÇؼ
Á¢±ÙÇÏ¿©, Balloon cath·Î ³ÐÇô ÁÖ´Â ½Ã¼ú
Indication: ¾ç¼ºÇùÂø(benign stricture)
- ¼ö¼ú(surgery)
- ´ã¼®(stone)
- ´ã°ü¿°(chplangitis)
»ç¿ë¹°Ç°: Balloon cath,Indeflation device
.035` G/W
Biliary stent placement
´ã°üÀÇ ÀϺΰ¡ ÇùÂøµÈ °æ¿ì PTBD tractÀ»
ÀÌ¿ëÇÏ¿© stent »ðÀÔÇÏ´Â ½Ã¼ú
Indication:
- ¼ö¼úºÒ°¡´ÉÇÑ ¾Ç¼ºÇùÂø
- ´ã°ü¾ÏÁ¾(cholangiocarcinoma)
- ÃéÀåµÎºÎ¾Ï(pancreas head cancer)
- ´ã³¶¾Ï(G