肥胖患者中胰胆支的进入及内镜逆行胰胆管造影术
Accessing the pancreatobiliary limb and ERCP in the bariatric patient.
作者信息
Khashab Mouen A, Okolo Patrick I
机构信息
Division of Gastroenterology and Hepatology, Department of Medicine, The Johns Hopkins Medical Institutions, Johns Hopkins University, 1830 East Monument Street, Room 1700A, Baltimore, MD 21205, USA.
出版信息
Gastrointest Endosc Clin N Am. 2011 Apr;21(2):305-13. doi: 10.1016/j.giec.2011.02.003.
The Roux-en-Y gastric bypass (RYGB) accounts for more than 60% of bariatric procedures performed in the United States today. The RYGB anatomy poses particular challenges to interventional endoscopists who intend to access the papilla. Deep enteroscopy-assisted endoscopic retrograde cholangiopancreatography seems to be the least invasive technique for this purpose, and is often the best initial choice. However, considerable experience is needed to optimize the success rate of reaching the biliopancreatic limb, with subsequent successful cannulation, and which approach is taken should be determined on a case-by-case basis.
目前在美国进行的减肥手术中， Roux-en-Y胃旁路术（RYGB）占比超过60%。RYGB的解剖结构给想要进入乳头的介入内镜医师带来了特殊挑战。深度肠镜辅助的内镜逆行胰胆管造影术似乎是实现这一目的侵入性最小的技术，通常也是最佳的初始选择。然而，需要相当多的经验来优化抵达胆胰支的成功率以及随后成功插管，具体采用哪种方法应根据具体情况而定。
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