Mavrogiannis C, Liatsos C, Romanos A, Goulas S, Dourakis S, Nakos A, Karvountzis G
Hippokration Athens Hospital and Department of Internal Medicine, Faculty of Nursing, Kappodistrian University of Athens, Greece.
Am J Gastroenterol. 1999 Apr;94(4):972-5. doi: 10.1111/j.1572-0241.1999.998_t.x.
Biliary sump syndrome is a rare complication of biliary-enteric anastomosis. Classically, the distal bile duct becomes obstructed by food, stones, or debris after choledochoenterostomy. Endoscopic sphincterotomy has been recommended as the primary and definitive treatment modality. The aim of our study was to confirm the short and long term therapeutic efficacy of endoscopic treatment in a long follow-up period.
The series include 31 patients with characteristic clinical illness after choledochoduodenostomy. All of them were successfully treated by endoscopic sphincterotomy and bile duct clearance with a balloon catheter or basket. The follow-up period ranged from 18 to 84 months (median: 51 months).
Clinical improvement was immediate in all patients. No complications were recorded. Recurrence of the syndrome, with restenosis of the sphincterotomy opening, was observed in six patients (19%) and was treated successfully and safely with a new papillotomy. Sump syndrome recurrence occurred 31-72 months (median: 58.5 months) after the initial treatment.
We report a considerably high recurrence rate of sump syndrome after initially successful endoscopic management and its effective endoscopic treatment with a new papillotomy. We still believe that the primary therapeutic approach in patients with sump syndrome should be endoscopic.
胆肠吻合口盲袢综合征是胆肠吻合术一种罕见的并发症。典型情况是，胆总管十二指肠吻合术后，远端胆管被食物、结石或碎屑阻塞。内镜下括约肌切开术已被推荐为主要的确定性治疗方式。我们研究的目的是在长期随访期内确认内镜治疗的短期和长期疗效。
该系列包括31例胆总管十二指肠吻合术后具有典型临床症状的患者。所有患者均通过内镜下括约肌切开术及使用球囊导管或网篮清除胆管内物质成功治疗。随访期为18至84个月（中位数：51个月）。
所有患者临床症状均立即改善。未记录到并发症。6例患者（19%）出现综合征复发，伴有括约肌切开开口再狭窄，通过再次乳头切开术成功且安全地进行了治疗。盲袢综合征复发发生在初始治疗后31至72个月（中位数：58.5个月）。
我们报告了在最初内镜治疗成功后，盲袢综合征相当高的复发率以及再次乳头切开术对其有效的内镜治疗。我们仍然认为，盲袢综合征患者的主要治疗方法应是内镜治疗。
