Surgical Gastrostomy for Pancreatobiliary and Duodenal Access Following Roux en Y Gastric Bypass
Surgical Gastrostomy for Pancreatobiliary and Duodenal Access Following Roux en Y Gastric Bypass
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Roux en Y 胃绕道术后胃造口术用于胰胆和十二指肠通路
DOI：
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发表时间：
2009
影响因子：
3.2
通讯作者：
E. Jensen
中科院分区：
文献类型：
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作者：
J. Gutierrez;H. Lederer;Jon C. Krook;T. Kinney;M. Freeman;E. Jensen
背景 Roux-en-Y 胃绕道手术 (RYGBP) 后的胰胆通路具有挑战性。我们回顾了 32 例复杂的经胃上消化道内窥镜检查的胃造口术病例。方法对 2004 年至 2008 年在单一机构进行胃造口术以获取胰胆和十二指肠通路的有 RYGBP 病史的患者前瞻性收集的数据库进行回顾性回顾。报告了手术指征、手术结果、成功插管和并发症。结果 30 名患者（25 名女性），年龄从 27 岁到 72 岁不等，接受了 32 次手术。进入残胃的指征包括Oddi括约肌功能障碍（13例）、胰腺炎（6例）、胆总管结石/梗阻（5例）、胆管炎（3例）、胰腺肿块评估（2例）、胃肠道出血（2例）和胆囊切除术后胆囊管漏（1例）。平均手术时间为 200 分钟 (98–338)，估计失血量（平均）85 cc (10–500)。 28 例患者尝试进行腹腔镜胃造口术，其中 1 例转为开腹（3.6%）。还进行了四次计划的开放手术。所有 30 名患者均成功接受了内窥镜检查，28 名患者接受了内镜逆行胰胆管造影，所有胰胆树插管均成功（100%）。 结论 胃造口术是 RYGBP 后进入上消化道和胰胆树的有效方法。当传统的内窥镜方法不可能时，应考虑该技术。
BackgroundPancreatobiliary access following Roux-en-Y gastric bypass (RYGBP) is challenging. We reviewed 32 cases of surgical gastrostomy for complex transgastric upper gastrointestinal endoscopy.MethodsRetrospective review of prospectively collected database of patients with history of RYGBP that had surgical gastrostomy for pancreatobiliary and duodenal access at a single institution from 2004–2008. Indication for procedure, surgical findings, successful cannulation, and complications are reported.ResultsThirty patients (25 female), with age ranging from 27 to 72, underwent 32 procedures. The indications to access the gastric remnant were sphincter of Oddi dysfunction (13), pancreatitis (six), common bile duct stone/obstruction (five), cholangitis (three), pancreatic mass evaluation (two), gastrointestinal bleed (two), and cystic duct leak after cholecystectomy (one). Mean operative time was 200 min (98–338) and estimated blood loss (mean) 85 cc (10–500). Laparoscopic gastrostomy was attempted in 28 cases with one conversion to open (3.6%). Four planned open procedures were also performed. All 30 patients underwent successful endoscopy and 28 had an endoscopic retrograde cholangiopancreatography, all with successful cannulation of the pancreatobiliary tree (100%).ConclusionsSurgical gastrostomy is an effective means to gain access to the upper GI tract and pancreatobiliary tree following RYGBP. This technique should be considered when traditional endoscopic approaches are impossible.
DOI：
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发表时间：
1993
期刊：
International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity
影响因子：
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作者：
Shiffman,ML;Sugerman,HJ;Kellum,JH;Brewer,WH;Moore,EW
通讯作者：
Moore,EW