Successful Intubation Using a Cap-Assisted Colonoscope for Endoscopic Retrograde Cholangiopancreatography in Patients Undergoing Roux-en-Y Reconstruction.
Successful Intubation Using a Cap-Assisted Colonoscope for Endoscopic Retrograde Cholangiopancreatography in Patients Undergoing Roux-en-Y Reconstruction.
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DOI：
10.3390/jcm12041353
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发表时间：
2023-02-08
影响因子：
3.9
通讯作者：
中科院分区：
文献类型：
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内镜逆行胆管造影（ERCP）对接受Roux-en-Y （REY）重建的患者具有挑战性；虽然气球辅助肠镜检查是一线治疗，但考虑到设备和专业知识，它并不总是可用的。我们的目的是评估在REY重建中使用帽辅助结肠镜作为ERCP主要方法的可行性。我们纳入了47例REY患者，他们在2017年1月至2022年2月期间使用帽辅助结肠镜进行ERCP。主要结果是在REY重建期间使用帽辅助结肠镜对ERCP插管成功。次要结果是插管成功、手术相关不良事件和影响插管成功的变量。比较侧对侧空肠造口术（SS-JJ）组和侧对端空肠造口术（SE-JJ）组，SS-JJ组插管成功率高于SE-JJ组（38例中34例（89.5%）比9例中1例（11.1%），p < 0.001）。SS-JJ组和SE-JJ组分别有37例（97.4%）和8例（88.9%）患者在仅使用结肠镜的失败ERCP中应用气囊辅助肠镜抢救技术后插管成功。无穿孔。多变量分析显示，SS-JJ是插管成功的预测因素（优势比[95%可信区间]= 37.06 [3.91 ~ 925.56],p = 0.005）。在接受REY重建的患者中，使用帽辅助结肠镜对ERCP至关重要。在解剖学上，SS-JJ可以方便和准确地识别传入肢，并使用帽辅助结肠镜进行高度成功的ERCP。
Endoscopic retrograde cholangiopancreatography (ERCP) is challenging in patients undergoing Roux-en-Y (REY) reconstruction; although balloon-assisted enteroscopy is the first-line treatment, it is not always available considering equipment and expertise. We aimed to evaluate the feasibility of using a cap-assisted colonoscope as the primary approach for ERCP in REY reconstruction. We included 47 patients with REY who underwent ERCP using a cap-assisted colonoscope between January 2017 and February 2022. The primary outcome was intubation success for ERCP using a cap-assisted colonoscope during REY reconstruction. The secondary outcomes were cannulation success, procedure-related adverse events, and variables affecting successful intubation. Comparing side-to-side jejunojejunostomy (SS-JJ) and side-to-end jejunojejunostomy (SE-JJ) groups, the intubation success rate using a cap-assisted colonoscope in the SS-JJ group was higher than that in the SE-JJ group (34 of 38 (89.5%) vs. 1 of 9 (11.1%), p < 0.001). Successful intubation was achieved in 37 (97.4%) and 8 (88.9%) patients in the SS-JJ and SE-JJ groups, respectively, after applying the rescue technique using a balloon-assisted enteroscope for failed ERCP using only a colonoscope. No perforation occurred. Multivariable analysis showed that SS-JJ was a predictive factor for successful intubation (odds ratio [95% confidence interval] = 37.06 [3.91–925.56], p = 0.005). Usage of a cap-assisted colonoscope can be crucial for ERCP in patients undergoing REY reconstruction. Anatomically, SS-JJ can facilitate easy and accurate identification of the afferent limb and a highly successful ERCP using a cap-assisted colonoscope.
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DOI：
10.1111/j.1440-1746.2006.04765.x
发表时间：
2007-08-01
影响因子：
4.1
作者：
Cicek, Bahattin;Parlak, Erkan;Sahin, Burhan
通讯作者：
Sahin, Burhan
影响因子：
4.1
作者：
Shimatani, Masaaki;Tokuhara, Mitsuo;Okazaki, Kazuichi
通讯作者：
Okazaki, Kazuichi
影响因子：
9.3
作者：
Dumonceau, Jean-Marc;Kapral, Christine;van Hooft, Jeanin E.
通讯作者：
van Hooft, Jeanin E.
影响因子：
4.1
作者：
Tokuhara, Mitsuo;Shimatani, Masaaki;Okazaki, Kazuichi
通讯作者：
Okazaki, Kazuichi
影响因子：
7.7
作者：
Wright, BE;Cass, OW;Freeman, ML
通讯作者：
Freeman, ML