Lee Alexander, Shah Janak N
Division of Gastroenterology, University of California, San Francisco, San Francisco, CA 94143, USA.
Gastrointest Endosc Clin N Am. 2013 Apr;23(2):483-504. doi: 10.1016/j.giec.2012.12.005. Epub 2013 Jan 12.
Endoscopic retrograde cholangiopancreatography (ERCP) in surgically altered anatomy can be technically challenging, because of three main problems that must be overcome: (1) endoscopically traversing the altered luminal anatomy, (2) cannulating the biliary orifice from an altered position, and (3) performing biliary interventions with available ERCP instruments. This article addresses the most common and most challenging variations in anatomy encountered by a gastroenterologist performing ERCP. It also highlights the innovations and progress that have been made in coping with these anatomic variations, with special attention paid to altered anatomy from bariatric surgery.
在内镜逆行胰胆管造影术（ERCP）应用于手术改变的解剖结构时，技术上可能具有挑战性，因为必须克服三个主要问题：（1）在内镜下穿过改变的管腔解剖结构；（2）从改变的位置插入胆管开口；（3）使用现有的ERCP器械进行胆道干预。本文探讨了胃肠病学家在进行ERCP时遇到的最常见且最具挑战性的解剖结构变异。还强调了在应对这些解剖结构变异方面所取得的创新和进展，特别关注了减肥手术导致的解剖结构改变。
