Double-balloon enteroscopy-assisted endoscopic retrograde cholangiography for Roux-en-Y reconstruction patients with papilla of Vater or bilioenteric anastomosis
Double-balloon enteroscopy-assisted endoscopic retrograde cholangiography for Roux-en-Y reconstruction patients with papilla of Vater or bilioenteric anastomosis
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DOI：
10.3109/00365521.2015.1056223
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发表时间：
2016-01-02
影响因子：
1.9
通讯作者：
Wu, Chin-Chieh
中科院分区：
文献类型：
--
作者：
Tsou, Yung-Kuan;Lee, Mu-Shien;Wu, Chin-Chieh
目标。Roux-en-Y重建在内镜逆行胆管造影（ERC）中可分为完整的Vater乳头和胆肠吻合（BEA）。双球囊肠镜辅助ERC （DBE-ERC）可能在两种人群中产生不同的结果，但缺乏研究。材料和方法。2007年7月至2013年8月，47例Roux-en-Y吻合患者接受了73例DBE-ERC手术。A组为完整乳头14例，B组为BEA 33例。回顾性分析比较两组间DBE-ERC的疗效，包括到达盲端数据、ERC表现、内镜治疗结果、随访等。结果。对于达到盲端，两组间成功率无差异（85.7% vs. 81.8%, p = 0.7），但A组平均手术时间明显缩短（28 min vs. 52 min, p = 0.01）。对于ERC，两组之间的成功率没有差异（91.7%对96.3%,p = 0.53），但A组的平均手术时间明显更长（28.4分钟对4分钟，p < 0.001）。两组均可成功进行内镜治疗。在平均26.1个月的随访期间，没有A组患者和5例（23.8%）B组患者出现复发性胆道狭窄/结石需要干预。结论。DBE-ERC对两组胆道疾病患者均有效。达到盲区比较困难，但对于BEA患者而言，ERC在手术时间而不是成功率方面更容易。
Objective. Roux-en-Y reconstructions can be divided into intact papilla of Vater and bilioenteric anastomosis (BEA) with respect to endoscopic retrograde cholangiography (ERC). Double-balloon enteroscopy-assisted ERC (DBE-ERC) may produce different results between the two populations but lacks studies. Material and methods. Forty-seven patients with Roux-en-Y anastomosis undergoing 73 procedures of DBE-ERC were enrolled between July 2007 and August 2013. There were 14 patients with intact papilla of Vater (group A) and 33 patients with BEA (group B). The effectiveness of DBE-ERC, including data of reaching the blind end, performance of ERC, results of endoscopic therapies, and follow-up were retrospectively analyzed and compared between the two groups. Results. For reaching the blind end, the success rate was not different between the groups (85.7% vs. 81.8%, p = 0.7), but the mean procedure time was significantly shorter for group A (28 min vs. 52 min, p = 0.01). For ERC, the success rate was not different between the groups (91.7% vs. 96.3%, p = 0.53), but the mean procedure time was significantly longer for group A (28.4 min vs. 4 min, p < 0.001). All endoscopic therapies could be successfully performed in both groups. No group A patients and five (23.8%) group B patients developed recurrent biliary stricture/stones requiring interventions during a mean follow-up period of 26.1 months. Conclusions. DBE-ERC was effective for both populations with biliary disorders. Reaching the blind end was more difficult but ERC was easier for patients with BEA in terms of procedure time rather than success rates.