Department of Gastroenterology, Sendai City Medical Center, Sendai, Japan.
Dig Endosc. 2013 Nov;25(6):601-7. doi: 10.1111/den.12039. Epub 2013 Jan 29.
The aim of the present study was to evaluate the usefulness of a single-balloon enteroscope (SBE) including a newly developed short SBE (SIF-Y0004) for therapeutic endoscopic retrograde cholangiography (ERC) in patients with Roux-en-Y (R-Y) anastomosis.
Therapeutic ERC using a SBE was attempted in 19 cases (41 procedures) with R-Y anastomosis after gastrectomy. A standard SBE (working length of 200 cm, working channel of 2.8 mm) was used in 11 cases (Group L), and a short SBE (working length of 152 cm, working channel of 3.2 mm) was used in eight cases (Group S).
Insertion of the scope up to the major papilla was achieved in 79% (15/19) of cases. Average insertion time was 37.0 ± 13.8 min (range, 19-62 min). Bile duct cannulation rate was 79% (11/14) after exclusion of the initial case in which scope exchange was unsuccessful. Average procedure time was78.8 ± 26.9 min (18-119 min). The scheduled therapeutic procedure was completed in 67% (10/15) of the cases (53% [10/19] on an intention-to-treat basis). Cardiorespiratory suppression due to sedative agents resulting in scope withdrawal developed in one procedure (2.4%; 1/41). Although there was no significant difference in therapeutic results between the two groups, the number of procedures was smaller (1.8 ± 1.3 vs 3.6 ± 3.1; P = 0.286) in Group S than in Group L.
Therapeutic ERC using a SBE for patients with R-Y anastomosis is considered to be safe and effective. A short SBE appears to be promising for further improvement in therapeutic results.
本研究旨在评估单气囊小肠镜（SBE）在 Roux-en-Y（R-Y）吻合术后患者中的应用价值，包括一种新开发的短 SBE（SIF-Y0004）在治疗性内镜逆行胆管造影（ERC）中的应用。
对 19 例胃切除术后 R-Y 吻合患者尝试进行 SBE 治疗性 ERC。11 例（L 组）使用标准 SBE（工作长度 200cm，工作通道 2.8mm），8 例（S 组）使用短 SBE（工作长度 152cm，工作通道 3.2mm）。
19 例中有 79%（15/19）的病例成功插入至主乳头。平均插入时间为 37.0±13.8min（19-62min）。排除初始因交换不成功而无法插管的病例后，胆管插管率为 79%（11/14）。平均手术时间为 78.8±26.9min（18-119min）。15 例（意向治疗基础上的 67%[10/19]）完成了预定的治疗程序。1 例（2.4%；41 例中有 1 例）因镇静剂导致心肺抑制而撤回内镜。两组间治疗效果无显著差异，但 S 组的操作次数较少（1.8±1.3 比 3.6±3.1；P=0.286）。
对于 R-Y 吻合术后患者，使用 SBE 进行治疗性 ERC 被认为是安全有效的。短 SBE 似乎有望进一步提高治疗效果。
