双气囊小肠镜在胆总管囊肿行Roux-en-Y肝空肠吻合术后肝内胆管结石治疗中的疗效
The efficacy of double-balloon enteroscopy for intrahepatic bile duct stones after Roux-en-Y hepaticojejunostomy for choledochal cysts.
作者信息
Ono Shigeru, Maeda Kosaku, Baba Katsuhisa, Usui Yoshiko, Tsuji Yuki, Yano Tomonori, Hatanaka Wataru, Yamamoto Hironori
机构信息
Division of Pediatric Surgery, Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-city, Tochigi, Japan,
出版信息
Pediatr Surg Int. 2013 Nov;29(11):1103-7. doi: 10.1007/s00383-013-3376-7.
INTRODUCTION
Intrahepatic bile duct (IHBD) stones are one of the most complicated morbidities that occur after Roux-en-Y hepaticojejunostomy (RYH); however, the optimal therapeutic approach is controversial.
METHODS
Double-balloon enteroscopy (DBE) has been widely and frequently performed even in pediatric patients. We herein report the successful management of IHBD stones by biliary lithotripsy using DBE after RYH for a choledochal cyst (CC). DBE has made it possible to perform endoscopic therapeutic intervention, including balloon dilatation of an anastomotic stricture and removal of IHBD stones, without any major complications.
CONCLUSION
DBE is a less invasive and safe treatment method for IHBD stones in pediatric patients, which is capable of reaching the bilioenteric anastomosis after RYH for CC.
引言
肝内胆管（IHBD）结石是 Roux-en-Y 肝空肠吻合术（RYH）后发生的最复杂病症之一；然而，最佳治疗方法存在争议。
方法
双气囊小肠镜检查（DBE）即使在儿科患者中也已广泛且频繁地进行。我们在此报告了在因胆总管囊肿（CC）行 RYH 术后，使用 DBE 通过胆道碎石术成功治疗 IHBD 结石的病例。DBE 使得在内镜下进行治疗性干预成为可能，包括对吻合口狭窄进行球囊扩张以及清除 IHBD 结石，且无任何重大并发症。
结论
DBE 是治疗儿科患者 IHBD 结石的一种侵入性较小且安全的治疗方法，能够在因 CC 行 RYH 术后抵达胆肠吻合口。
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