Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, 1830 East Monument Street, Baltimore, MD 21205, USA.
Dig Dis Sci. 2012 May;57(5):1391-8. doi: 10.1007/s10620-011-2000-8. Epub 2011 Dec 25.
Endoscopic retrograde cholangiopancreatography (ERCP) is often unsuccessful in patients with Roux-en-Y anatomy. Augmented enteroscopy allows deep insertion into the small bowel and can be useful in patients with Roux-en-Y anatomy. The aim of this study was to compare single balloon assisted ERCP (SBE-ERCP) and spiral assisted ERCP (SE-ERCP) in patients with Roux-en-Y anatomy in terms of diagnostic and therapeutic yield, procedure time, and complications.
This is a retrospective cohort study of consecutive patients with Roux-en-Y anatomy who underwent SBE-ERCP or SE-ERCP between October 2007 and March 2011. Diagnostic yield was defined as successful duct cannulation. Therapeutic yield was defined as the ability to successfully carry out endoscopic therapy in those cannulated. Procedure time and complications were assessed.
Thirty-four consecutive patients with Roux-en-Y anatomy underwent 54 ERCP procedures. The overall diagnostic yield was 44.4% with no significant difference between the diagnostic yield of SBE-ERCP (48.3%) and SE-ERCP (40%). The diagnostic yield was lower in patients with gastric by-pass (38.9%) compared with other types of Roux-en-Y anatomy (47.2%) but this was not statistically significant (P = 0.772). The overall therapeutic yield was 93.8%, with a therapeutic yield of 100% for SBE-ERCP and 87.5% for SE-ERCP (P = 1.0). There was one perforation during SBE-ERCP, giving a complication rate of 3.5%. The mean procedure time did not differ between the two techniques.
Diagnostic and therapeutic yields are similar with SBE-ERCP and SE-ERCP in patients with Roux-en-Y anatomy with no significant difference in procedure time or complication rates.
内镜逆行胰胆管造影术（ERCP）在 Roux-en-Y 解剖结构的患者中往往不成功。增强型小肠镜检查可以深入插入小肠，对于 Roux-en-Y 解剖结构的患者非常有用。本研究的目的是比较 Roux-en-Y 解剖结构患者中使用单球囊辅助 ERCP（SBE-ERCP）和螺旋辅助 ERCP（SE-ERCP）在诊断和治疗效果、手术时间和并发症方面的差异。
这是一项回顾性队列研究，连续纳入 2007 年 10 月至 2011 年 3 月期间接受 SBE-ERCP 或 SE-ERCP 的 Roux-en-Y 解剖结构患者。诊断效果定义为成功胆管插管。治疗效果定义为在插管患者中成功进行内镜治疗的能力。评估手术时间和并发症。
34 例 Roux-en-Y 解剖结构患者共行 54 次 ERCP 检查。整体诊断效果为 44.4%，SBE-ERCP（48.3%）和 SE-ERCP（40%）的诊断效果无显著差异。胃旁路术（38.9%）患者的诊断效果低于其他类型的 Roux-en-Y 解剖结构（47.2%），但差异无统计学意义（P=0.772）。整体治疗效果为 93.8%，SBE-ERCP 的治疗效果为 100%，SE-ERCP 为 87.5%（P=1.0）。SBE-ERCP 发生 1 例穿孔，并发症发生率为 3.5%。两种技术的手术时间无显著差异。
SBE-ERCP 和 SE-ERCP 在 Roux-en-Y 解剖结构患者中的诊断和治疗效果相似，手术时间和并发症发生率无显著差异。
