Endoscopic retrograde cholangiography by double balloon enteroscopy in patients with Roux-en-Y hepaticojejunostomy
Endoscopic retrograde cholangiography by double balloon enteroscopy in patients with Roux-en-Y hepaticojejunostomy
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DOI：
10.1007/s00464-009-0591-3
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发表时间：
2010-02-01
影响因子：
3.1
通讯作者：
Sahin, Burhan
中科院分区：
文献类型：
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作者：
Parlak, Erkan;Cicek, Bahattin;Sahin, Burhan
在肝管空肠Roux-en-Y吻合术（HJ）患者中，通常无法进行内镜逆行胆管造影（ERC），因为标准十二指肠镜无法到达吻合口。在这项研究中，我们报告了使用双气囊小肠镜（DBE）（DBE-ERC）对HJ患者进行ERC的经验。自2006年5月3日完成的索引病例以来，我们对DBE-ERC手术进行了综述。DBE-ERC在所有患者中均获得成功，但有1例患者无法达到吻合口（达到吻合口的成功率：92.9%）。其余13例患者（7例女性，6例男性;年龄28-61岁，平均45.3岁）接受了20次DBE-ERC。所有患者均完成胆管插管。手术包括括约肌成形术、扩张术、取石术和支架置入术。治疗过程都是成功的，除了一个病人，谁有胆总管充满了多个结石，并被转诊手术。3例吻合口狭窄的患者在支架取出后分别在3个月、9个月和12个月随访时无症状。在狭窄成形术后的患者中检测到腹膜后空气，但仅通过药物治疗即可恢复。平均持续时间的程序是75 +/- A 62分钟。DBE-ERCP使我们能够进行ERC的一组患者，这是不可能的。与其他方法相比，需要进一步的经验来评估其治疗效果。
In patients with Roux-en-Y hepaticojejunostomy (HJ), endoscopic retrograde cholangiography (ERC) cannot usually be achieved since the anastomosis is not reachable via standard duodenoscope. In this study, we report our experience with ERC using double balloon enteroscope (DBE) (DBE-ERC) in patients with HJ.The DBE-ERC procedures performed since the index case done dated May 3, 2006 have been overviewed.Fourteen patients underwent the procedure. DBE-ERC was successful in all but one patient, for whom the anastomosis could not be reached (success rate to reach anastomosis: 92.9%). The remaining 13 patients (7 female, 6 male; age 28-61 years, mean 45.3 years) had 20 sessions of DBE-ERC. The cannulation of the bile duct was achieved in all patients. The procedures, such as sphincteroplasty, dilatation, stone extraction and stent placement, were performed. Therapeutic procedures were all successful, except for in a single patient, who had the common bile duct filled with multiple stones and was referred for surgery. Three patients who had anastomotic stenosis treated by stenting are symptom free on follow-up at 3, 9 and 12 months, respectively, after stent removal. Retroperitoneal air was detected in a patient following stricturoplasty, but recovery was attained with medical treatment alone. Mean duration of the procedures was 75 +/- A 62 min.DBE-ERCP enables us to perform ERC in a group of patients for whom it was impossible previously. Further experience is needed to evaluate its therapeutic efficacy compared with alternative methods.