新型短型双气囊内镜在术后患者内镜逆行胆管造影中的应用价值。

Utility of newly developed short-type double-balloon endoscopy for endoscopic retrograde cholangiography in postoperative patients.

作者信息

Shimatani Masaaki, Tokuhara Mitsuo, Kato Kota, Miyamoto Sachi, Masuda Masataka, Sakao Masayuki, Fukata Norimasa, Miyoshi Hideaki, Ikeura Tsukasa, Takaoka Makoto, Okazaki Kazuichi

机构信息

Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University, Osaka, Japan.

出版信息

J Gastroenterol Hepatol. 2017 Jul;32(7):1348-1354. doi: 10.1111/jgh.13713.

DOI:10.1111/jgh.13713

PMID:28019036

Abstract

BACKGROUND AND AIM

The utility of conventional short-type double-balloon endoscopy (DBE) for pancreatobiliary disease in patients with postoperative anatomy had been widely acknowledged and accepted. However, some technical difficulties yet remained. In an attempt to solve these problems, the new short-type DBE (N-short DBE) was uniquely designed for therapeutic endoscopic retrograde cholangiography (ERC) in postoperative patients. The aim of this study was to evaluate the usefulness of N-short DBE for ERC in postoperative patients.

METHODS

From August 2015 to April 2016, ERC using N-short DBE (DB-ERC) was performed in 100 postoperative patients (112 procedures). We retrospectively studied the success rate of reaching the blind end, the median time to reach the blind end, the diagnostic success rate, the therapeutic success rate, the median time to complete ERC-related interventions, the overall success rate, the median time to complete DB-ERC, and adverse events.

RESULTS

The success rate of reaching the blind end was 99.1%. The median time to reach the blind end was 10 min (interquartile range [IQR], 6-19 min). The diagnostic success rate was 98.2%. The therapeutic success rate was 100%. The median time to complete ERC-related interventions was 36 min (IQR, 22-62 min). The overall DB-ERC success rate was 97.3%. The median time to complete DB-ERC was 54 min (IQR, 37-73 min). The occurrence of adverse events was 2.7%.

CONCLUSIONS

The N-short DBE for ERC in postoperative patients is useful and safe. DB-ERC is promising therapeutic modality in such patients and should be selected as the first-line policy.

摘要

背景与目的

传统短型双气囊小肠镜（DBE）在术后解剖结构患者的胰胆疾病中的应用已得到广泛认可和接受。然而，仍存在一些技术难题。为解决这些问题，新型短型DBE（N-短型DBE）专为术后患者的治疗性内镜逆行胆管造影（ERC）而独特设计。本研究旨在评估N-短型DBE在术后患者ERC中的实用性。

方法

2015年8月至2016年4月，对100例术后患者（共进行112例操作）使用N-短型DBE进行ERC（DB-ERC）。我们回顾性研究了到达盲端的成功率、到达盲端的中位时间、诊断成功率、治疗成功率、完成ERC相关干预的中位时间、总体成功率、完成DB-ERC的中位时间以及不良事件。

结果

到达盲端的成功率为99.1%。到达盲端的中位时间为10分钟（四分位间距[IQR]，6 - 19分钟）。诊断成功率为98.2%。治疗成功率为100%。完成ERC相关干预的中位时间为36分钟（IQR，22 - 62分钟）。DB-ERC的总体成功率为97.3%。完成DB-ERC的中位时间为54分钟（IQR，37 - 73分钟）。不良事件发生率为2.7%。