Therapeutic endoscopic retrograde cholangiography using a single-balloon enteroscope in patients with Roux-en-Y anastomosis
Therapeutic endoscopic retrograde cholangiography using a single-balloon enteroscope in patients with Roux-en-Y anastomosis
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DOI：
10.1111/den.12039
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发表时间：
2013-11-01
影响因子：
5.3
通讯作者：
Masu, Kaori
中科院分区：
文献类型：
--
作者：
Obana, Takashi;Fujita, Naotaka;Masu, Kaori
背景本研究的目的是评估单球囊肠镜 (SBE)（包括新开发的短 SBE (SIF-Y0004)）对 Roux-en-Y (R-Y) 吻合术患者进行治疗性内镜逆行胆管造影 (ERC) 的有用性。患者和方法在 19 例胃切除术后 R-Y 吻合术患者（41 例手术）中尝试使用 SBE 进行治疗性 ERC。 11例（L组）使用标准SBE（工作长度200cm，工作通道2.8mm），8例（S组）使用短SBE（工作长度152cm，工作通道3.2mm）。结果79%（15/19）的病例实现镜体插入至主乳头。平均插入时间为 37.013.8 分钟（范围：19-62 分钟）。排除内镜更换不成功的初始病例后，胆管插管率为 79% (11/14)。平均手术时间为 78.8 +/- 26.9 分钟（18-119 分钟）。 67% (10/15) 的病例完成了预定的治疗程序（53% [10/19] 基于意向治疗）。一次手术中因镇静剂导致心肺抑制导致范围撤回（2.4%；1/41）。虽然两组治疗效果无显着差异，但S组手术次数少于L组（1.8±1.3 vs 3.6±3.1；P=0.286）。 结论采用SBE治疗R-Y吻合患者的ERC被认为是安全有效的。短期 SBE 似乎有望进一步改善治疗结果。
BackgroundThe aim of the present study was to evaluate the usefulness of a single-balloon enteroscope (SBE) including a newly developed short SBE (SIF-Y0004) for therapeutic endoscopic retrograde cholangiography (ERC) in patients with Roux-en-Y (R-Y) anastomosis.Patients and MethodsTherapeutic ERC using a SBE was attempted in 19 cases (41 procedures) with R-Y anastomosis after gastrectomy. A standard SBE (working length of 200cm, working channel of 2.8mm) was used in 11 cases (Group L), and a short SBE (working length of 152cm, working channel of 3.2mm) was used in eight cases (Group S).ResultsInsertion of the scope up to the major papilla was achieved in 79% (15/19) of cases. Average insertion time was 37.013.8min (range, 19-62min). Bile duct cannulation rate was 79% (11/14) after exclusion of the initial case in which scope exchange was unsuccessful. Average procedure time was78.8 +/- 26.9min (18-119min). The scheduled therapeutic procedure was completed in 67% (10/15) of the cases (53% [10/19] on an intention-to-treat basis). Cardiorespiratory suppression due to sedative agents resulting in scope withdrawal developed in one procedure (2.4%; 1/41). Although there was no significant difference in therapeutic results between the two groups, the number of procedures was smaller (1.8 +/- 1.3 vs 3.6 +/- 3.1; P=0.286) in Group S than in Group L.ConclusionsTherapeutic ERC using a SBE for patients with R-Y anastomosis is considered to be safe and effective. A short SBE appears to be promising for further improvement in therapeutic results.