Tsutsumi Koichiro, Kato Hironari, Okada Hiroyuki
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
Gut Liver. 2017 Mar 15;11(2):306-311. doi: 10.5009/gnl16441.
A newly developed short double-balloon enteroscope with a working channel enlarged to a diameter of 3.2 mm is a novel innovation in stent placement for patients with surgically altered anatomies. Herein, we report three patients in whom this new scope contributed to an efficient technique and ideal treatment. In the first case, the double guidewire technique was efficient and effective for multiple stent placements. In the second case, covered self-expandable metal stent (SEMS) placement, which is the standard treatment for malignant biliary obstruction, could be performed in a technologically sound and safe manner. In the third case, SEMS placement was performed as palliative treatment for malignant afferent-loop obstruction; this procedure could be performed soundly and safely using the through-the-scope technique. The wider working channel of this new scope also facilitates a smoother accessory insertion and high suction performance, which reduces procedure time and stress on endoscopists. Furthermore, this new scope, which has advanced force transmission, adaptive bending, and a smaller turning radius, is expected to be highly successful in both diagnosis and therapy for various digestive diseases in patients with surgically altered anatomies.
一种新开发的短双气囊小肠镜,其工作通道直径扩大到3.2毫米,这是外科解剖结构改变患者支架置入方面的一项新创新。在此,我们报告三例患者,这种新内镜促成了高效技术和理想治疗。第一例中,双导丝技术对多个支架置入高效且有效。第二例中,对于恶性胆道梗阻的标准治疗——覆膜自膨式金属支架(SEMS)置入,能够以技术完善且安全的方式进行。第三例中,SEMS置入作为恶性输入袢梗阻的姑息治疗;使用经内镜技术能够完善且安全地进行该操作。这种新内镜更宽的工作通道也便于附件更顺畅地插入以及实现高抽吸性能,这减少了操作时间和内镜医师的压力。此外,这种新内镜具有先进的力传递、自适应弯曲以及更小的转弯半径,有望在外科解剖结构改变患者的各种消化系统疾病的诊断和治疗中都取得高度成功。