Endoscopic retrograde cholanglopancreatography in patients with Billroth II gastroenterostorny
Endoscopic retrograde cholanglopancreatography in patients with Billroth II gastroenterostorny
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DOI：
10.1111/j.1440-1746.2006.04765.x
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发表时间：
2007-08-01
影响因子：
4.1
通讯作者：
Sahin, Burhan
中科院分区：
文献类型：
--
作者：
Cicek, Bahattin;Parlak, Erkan;Sahin, Burhan
背景与目的：Billroth II胃肠吻合术(B II GE)患者，尤其是Braun吻合术(BA)患者，内窥镜逆行胆胰管造影术(ERCP)更为复杂。方法：回顾分析近2.5年来行ERCP检查的BII型GE患者的临床资料。结果：52例单纯BII型GE和7例合并BA的BIIGE患者在此期间接受了ERCP。胆总管插管成功率分别为43/52(83%)和2/7(29%)。9例B II GE患者治疗失败原因分别为传入环口肿瘤浸润性病变1例、乳头状瘤周围肿瘤侵犯2例、传入环入路不畅2例、传入环长4例。总体而言，10.2%(6/59)的患者发生了穿孔。其中2例死亡(2/59，3.4%)，1例(1/59，1.7%)合并胰腺炎。结论：虽然ERCP在大部分B II GE患者中取得了成功，但仍存在穿孔等风险。ERCP必须由经验丰富的内窥镜医生在拥有适当设施来处理内窥镜相关并发症的机构中进行。
Background and Aim: Endoscopic retrograde cholangiopancreatography (ERCP) is more complicated in patients with Billroth II gastroenterostomy (B II GE) especially in those associated with Braun anastomosis (BA). The aim of the present study was to review experience of ERCP in patients with B II GE.Methods: The records of patients with B II GE who had undergone an ERCP within the last 2.5 years were retrospectively evaluated.Results: Fifty-two patients with simple B II GE and seven with additional BA underwent ERCP within this period. The probability of common bile duct cannulation and success of nt was 43/52 (83%) and 2/7 (29%) in the respective groups. The reasons endoscopic treatment for failure were long afferent loop in patients with BA; for the nine patients with B II GE the reasons for failure were tumoral infiltration at the orifice of afferent loop in one patient, peripapillary tumoral invasion in two patients, failure of entrance to the afferent loop due to angulation in two patients, and long afferent loop in the remaining four patients. Overall, perforation developed in 10.2% (6/59 of the patients. Two of these patients died (2/59, 3.4%) and one (1/59, 1.7%) had concomitant pancreatitis.Conclusions: Although ERCP is successful in a large proportion of patients with B II GE, it carries significant risks such as perforation. ERCP must be performed by experienced endoscopists at institutions that have suitable facilities to manage endoscopy-related complications.