Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, The Netherlands.
Endoscopy. 2017 Feb;49(2):181-185. doi: 10.1055/s-0042-118311. Epub 2016 Oct 19.
Guidelines recommend surveillance endoscopy with both forward- and side-viewing endoscopes to identify duodenal and ampullary adenomas in patients with familial adenomatous polyposis (FAP). We hypothesized that both the duodenum and the ampulla of Vater can be completely visualized during cap-assisted forward-viewing endoscopy. A total of 40 patients with FAP underwent forward-viewing endoscopy with a short cap attached to the tip of the gastroscope, with the aim of visualizing both the duodenum and the ampulla of Vater. If unsuccessful, the procedure was followed by a side-viewing endoscopy. Adverse events were reported. The duodenum, including the ampulla of Vater, was completely visualized using the cap in 38/40 patients (95.0 %). The ampulla could not be visualized using the cap in two patients, both of whom underwent additional side-viewing endoscopy, which was successful. No adverse events occurred. This study showed that cap-assisted endoscopy can be used effectively and safely to visualize both the duodenum and the ampulla of Vater in patients with FAP. This practice might reduce burden, time, and costs of an additional side-viewing endoscopy.
指南建议对家族性腺瘤性息肉病（FAP）患者进行经前视和侧视内镜检查，以识别十二指肠和壶腹腺瘤。我们假设在帽辅助前视内镜检查中可以完全观察到十二指肠和壶腹。 共有 40 例 FAP 患者接受了带有短帽的前视内镜检查，目的是观察十二指肠和壶腹。如果不成功，则进行侧视内镜检查。报告了不良事件。 帽在 38/40 例患者（95.0%）中完全观察到了十二指肠，包括壶腹。有两名患者无法使用帽观察到壶腹，这两名患者均接受了额外的侧视内镜检查，均成功。没有发生不良事件。 本研究表明，帽辅助内镜检查可有效、安全地观察 FAP 患者的十二指肠和壶腹。这种做法可能会减少额外侧视内镜检查的负担、时间和成本。
