床边无射线“ERCP”，打通胆道“交通堵塞”

Core Viewpoint - The article highlights a successful emergency medical intervention for an 80-year-old patient suffering from acute cholangitis, showcasing the collaboration between ICU and gastroenterology teams in a challenging situation without the use of X-ray guidance [1][2][3][4]. Group 1: Patient Condition and Diagnosis - The patient, referred to as Zhang, was diagnosed with "multiple stones in the common bile duct combined with acute suppurative cholangitis," leading to severe complications including infection and acute renal failure [2]. - Despite aggressive antibiotic treatment, the patient's condition did not improve, necessitating urgent intervention to relieve the blockage in the bile duct [2]. Group 2: Emergency Response and Treatment Approach - Due to the patient's age and critical condition, a standard transfer to the endoscopy center was deemed too risky; thus, a decision was made to perform a bedside ERCP without X-ray guidance [2][3]. - The medical team, led by Dr. Ma and supported by Nurse Zhao, quickly mobilized to the ICU with the necessary equipment to perform the procedure [2]. Group 3: Surgical Procedure and Challenges - The surgery commenced under strict monitoring, relying solely on the medical team's experience and coordination, as there was no X-ray equipment available [3]. - Significant challenges included the patient's pylorus being in spasm and anatomical variations that complicated access to the bile duct, requiring multiple attempts and adjustments during the procedure [4]. Group 4: Outcome and Recovery - The procedure successfully re-established the bile duct's patency by placing a stent, which allowed for effective drainage and control of the infection [4]. - Following the intervention, the patient showed signs of recovery, including the removal of the ventilator support, indicating a positive outcome from the critical care provided [4].