Maluf-Filho Fauze, Kumar Atul, Ferreria de Souza Thiago, Cortas George, Halwan Bhawna, Humberto Giordano-Nappi José, Sakai Paulo
Drs. Maluf-Filho serve as Associate Professors at the University of São Paulo School of Medicine in São Paulo, Brazil.
Gastroenterol Hepatol (N Y). 2008 Jan;4(1):59-62.
In patients who have undergone prior Billroth-II (B-II) anastomosis, endoscopic retrograde cholangiopancreatography (ERCP) is challenging due to altered duodenal anatomy, which requires use of customized sphincterotomes. We report the use of a standard rotat-able sphincterotome for successful cannulation in 5 patients with prior B-II gastrojejunostomy and 1 patient with choledochoduodenostomy. In our experience, cannulation and endoscopic intervention were successfully accomplished in all patients without any complications. Although retrospective case series analysis limits the conclusiveness of our findings, we believe that a rotatable sphincterotome can be successfully utilized to cannulate the common bile duct in patients with prior B-II anastomosis, thereby eliminating the need to maintain an inventory of specialized accessories.
对于既往接受过毕罗Ⅱ式（B-II）吻合术的患者，由于十二指肠解剖结构改变，内镜逆行胰胆管造影（ERCP）颇具挑战性，这需要使用定制的括约肌切开刀。我们报告了使用标准可旋转括约肌切开刀成功插管5例既往行B-II胃空肠吻合术的患者和1例胆总管十二指肠吻合术患者的情况。根据我们的经验，所有患者均成功完成插管及内镜干预，无任何并发症。尽管回顾性病例系列分析限制了我们研究结果的确定性，但我们认为可旋转括约肌切开刀可成功用于既往行B-II吻合术患者的胆总管插管，从而无需储备专门的附件。
