内視鏡的膵・胆管造影用カニューレの改良―コック付マンドリン留置式カニューレ

An Improvement in the Cannula for Endoscopic Pancreatocholangiography: The Cannula with fixed mandrin and stopcock

　近年，十二指腸ファイバースコープの開発により，内視鏡的膵・胆管造影（EPCG）が可能になり，これは膵・胆道系疾患の診断に欠かせない検査法となっている¹⁾．

　EPCGを行なうには，造影剤を注人するカニューレが必要である．われわれは市販のカニューレに若干の改良を加えたところ，より良好な造影像が得られるようになり，さらに検査時間の短縮，造影率の向上，副作用の減少など著明な改善をみたので報告する．

　We have made some improvements in the Cannula for endoscopic pancreatocholangiography as shown in the illustration. The improved Cannula has such advantages as the following.

　1) We can keep the Cannula filled with contrast medium through the time of cannulation, and there is no fear of injecting the air into the pancreatic duct or choledochus.

　2) The mandrin is fixed inside the Cannula, and we need not manipulate the mandrin, so that we can keep the inside of the Cannula aseptic.

　3) As we can close the stopcock during the cannulation, there is no fear of the duodenal juice flowing into the cannula and contrast medium dropping out into the duodenum.

　4) We can disinfect the cannula and the mandrin by letting a disinfectant run through the cannula.

　5) The cannula is long enough for an attending assistaut to manage injector.

　Five hundred and three cannulations have been performed by using this cannula resulting in 143 endoscopic pancreatograms, 279 endoscopic pancreatocholangiograms and 76 endoscopic cholangiograms.