Vilallonga Ramon, Pimentel Ronnie, Rosenthal Raul J
*The Bariatric and Metabolic Institute, Division of Minimally Invasive and Bariatric Surgery, Bariatric Institute †Department of Gastroenterology Advanced Therapeutic Endoscopy, Cleveland Clinic Florida, Weston, FL.
Surg Laparosc Endosc Percutan Tech. 2013 Oct;23(5):e188-90. doi: 10.1097/SLE.0b013e31828b85e8.
Obesity is the major risk factor in cholesterol crystal and gallstone formation. After an Roux-en-Y gastric bypass, biliary duct dilatation can appear and gallstone formation can cause biliary duct obstruction or gallstone pancreatitis. Management of this clinical situation can be challenging and many approaches have been reported. Endoscopic retrograde cholangiopancreatography plays an important role in the management of biliary duct obstruction in these patients. However, a previous modified anatomy makes this procedure technically difficult. For these reason, we describe our single-institution experience in the management of biliary duct obstruction utilizing a hybrid approach combining laparoscopy and flexible endoscopy.
肥胖是胆固醇结晶和胆结石形成的主要危险因素。在进行Roux-en-Y胃旁路手术后，可出现胆管扩张，胆结石形成可导致胆管梗阻或胆石性胰腺炎。处理这种临床情况具有挑战性，已有多种方法被报道。内镜逆行胰胆管造影术在这些患者的胆管梗阻处理中发挥着重要作用。然而，既往改变的解剖结构使该操作在技术上具有难度。基于这些原因，我们描述了我们单机构利用腹腔镜和软性内镜相结合的混合方法处理胆管梗阻的经验。
