Service des maladies de l'appareil digestif, Centre hospitalo-universitaire, Rennes, France.
Gastrointest Endosc. 2010 Aug;72(2):449-51. doi: 10.1016/j.gie.2010.03.1063. Epub 2010 Jun 11.
Endoscopic interventions are usually very challenging in patients with anatomic changes caused by earlier GI surgery. The recent development of the double-balloon enteroscopy (DBE) system creates an opportunity to reach the biliary tract and the pancreatic duct in postsurgical conditions.
To report a further application of DBE in surgical patients; namely, extraction of pancreatic stents placed in pancreaticojejunal anastomosis during pancreaticoduodenectomy.
Two case reports.
A single-center experience in a tertiary-care unit.
Two patients who underwent Whipple resection with Roux-en-Y reconstruction presented with migration of pancreatic stent tubes inserted in pancreaticojejunal anastomoses. Stents had migrated to the end of the afferent limb and were causing abdominal pain. Because extraction failed by using conventional endoscopy, we used the DBE system.
Successful extraction of the stents.
Stents were successfully removed in both patients with no complications. After 1 year of follow-up, the patients remained free of painful symptoms.
Small volume case series.
Double-balloon enteroscopy is a reliable way to investigate and treat patients with postsurgical altered anatomy. Here, we report the successful removal of pancreatic stents migrating into the jejunal loop through pancreaticojejunal anastomosis.
在因早期胃肠道手术引起解剖结构改变的患者中，内镜介入通常极具挑战性。双气囊小肠镜（DBE）系统的最新发展为在外科条件下到达胆道和胰管创造了机会。
报告 DBE 在外科患者中的进一步应用；即在胰十二指肠切除术后的胰肠吻合中提取放置的胰管支架。
两个病例报告。
在三级护理单位的单中心经验。
两名接受胰十二指肠切除术和 Roux-en-Y 重建的 Whipple 切除术患者出现胰肠吻合口插入的胰管支架管迁移。支架已迁移到输入襻的末端，并引起腹痛。由于常规内镜检查未能成功取出，我们使用了 DBE 系统。
支架成功取出。
两名患者均成功取出支架，无并发症。随访 1 年后，患者仍无疼痛症状。
小样本量病例系列。
双气囊小肠镜是一种可靠的方法，可用于调查和治疗外科手术后解剖结构改变的患者。在这里，我们报告了通过胰肠吻合成功取出迁移到空肠襻的胰管支架。
