Short-type single-balloon enteroscope-assisted ERCP in postsurgical altered anatomy: potential factors affecting procedural failure
Short-type single-balloon enteroscope-assisted ERCP in postsurgical altered anatomy: potential factors affecting procedural failure
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DOI：
10.1055/s-0042-118301
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发表时间：
2017-01-01
期刊：
影响因子：
9.3
通讯作者：
Nojima, Masanori
中科院分区：
文献类型：
--
作者：
Yane, Kei;Katanuma, Akio;Nojima, Masanori
背景和研究目的：短型单气囊小肠镜（short-type single-balloon enteroscope，short SBE）辅助内镜逆行胰胆管造影术（endoscopic retrograde cholangiopancreatography，ERCP）是一种有前途的替代治疗方法，可用于外科手术后解剖结构改变的治疗。但它在技术上要求很高，影响其技术难度的因素尚未明确。本研究旨在探讨短SBE辅助ERCP的手术成功率和影响手术失败的潜在因素。Patients and Methods共有117例连续患者（203例手术）与手术改变的解剖结构进行ERCP使用原型短SBE。结果小肠镜检查成功率为92.6%（95%CI 88.1%~ 95.8%），手术成功率为81.8%（95%CI 75.8%~ 86.8%）。多变量分析表明胰腺适应症（比值比[OR] 4.35，95% CI 1.67-11.4），首次ERCP尝试（OR 6.03，95% CI 2.17-16.8），无透明罩（OR 4.61，结论短SBE辅助ERCP对手术后解剖结构的改变是有效的。该大型病例系列表明了影响手术失败的潜在因素。
Background and study aims Short-type single-balloon enteroscope (short SBE)-assisted endoscopic retrograde cholangiopancreatography (ERCP) is a promising alternative treatment in post-surgical altered anatomy. However, it is technically demanding, and factors affecting its technical difficulty have not yet been clarified. This study aimed to examine the procedural success rate of short SBE-assisted ERCP and the potential factors affecting procedural failure.Patients and methods A total of 117 consecutive patients (203 procedures) with surgically altered anatomy underwent ERCP using prototype short SBEs. The procedural success rate of short SBE-assisted ERCP and the potential factors affecting procedural failure were examined retrospectively.Results The enteroscopy success rate and procedural success rate were 92.6% (95% confidence interval [CI] 88.1%-95.8%) and 81.8 % (95% CI 75.8%-86.8 %), respectively. Multivariate analyses indicated that pancreatic indication (odds ratio [OR] 4.35, 95% CI 1.67-11.4), first ERCP attempt (OR 6.03, 95% CI 2.17-16.8), and no transparent hood (OR 4.61, 95% CI 1.48-14.3) were potential risk factors for procedural failure.Conclusions Short SBE-assisted ERCP was effective in post-surgical altered anatomy. This large case series suggested the potential factors affecting procedural failure.