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新型短型单气囊小肠镜在Roux-en-Y胃切除术后患者内镜逆行胰胆管造影中的应用:一项初步研究

Usefulness of the "newly designed" short-type single-balloon enteroscope for ERCP in patients with Roux-en-Y gastrectomy: a pilot study.

作者信息

Tanisaka Yuki, Ryozawa Shomei, Mizuide Masafumi, Kobayashi Masanori, Fujita Akashi, Minami Kazuhiro, Kobatake Tsutomu, Omiya Kumiko, Iwano Hirotoshi, Araki Ryuichiro

机构信息

Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan.

Community Health Science Center, Saitama Medical University, Saitama, Japan.

出版信息

Endosc Int Open. 2018 Dec;6(12):E1417-E1422. doi: 10.1055/a-0754-2290. Epub 2018 Nov 29.

Abstract

In recent years, the short single-balloon enteroscope (SBE) has been used during endoscopic retrograde cholangiopancreatography (ERCP) for patients with surgically altered anatomy and has been reported to be useful. However, difficulties remain, and the procedures and devices need improvements. We assessed the usefulness and superiority of a new short SBE equipped with passive bending and high-force transmission by comparisons with outcomes using the conventional short SBE.  This study evaluated short SBE-assisted ERCP-related procedures for Roux-en-Y gastrectomy between September 2011 and October 2017. Outcomes including the procedural success rate, which was the primary outcome, were assessed to compare the conventional short SBE (SIF-Y0004 [prototype]) and the new short SBE (SIF-H290S).  Of 74 procedures performed in 61 patients, 51 procedures in 39 patients involved the SIF-Y0004, and 23 procedures in 22 patients involved the SIF-H290S. The procedural success rates were 70.6 % for SIF-Y0004, and 95.7 % for SIF-H290S, representing better results for the new short SBE (  = 0.02). The new short SBE also had a superior diagnostic success rate (  = 0.047) and median time to reach the blind end (  < 0.001).  Roux-en-Y gastrectomy patients treated with the new short SBE had better outcomes than those treated with conventional short SBE. More cases need to be studied; however, the new short SBE has the potential to improve ERCP outcomes in patients with surgically altered anatomy.

摘要

近年来,短型单气囊小肠镜(SBE)已用于解剖结构改变的患者的内镜逆行胰胆管造影(ERCP),且据报道效果良好。然而,困难依然存在,操作程序和设备仍需改进。我们通过与传统短型SBE的使用结果进行比较,评估了一种配备被动弯曲和高力传递功能的新型短型SBE的实用性和优越性。 本研究评估了2011年9月至2017年10月期间短型SBE辅助的Roux-en-Y胃切除术相关操作。评估了包括作为主要结局的操作成功率在内的各项结局,以比较传统短型SBE(SIF-Y0004[原型])和新型短型SBE(SIF-H290S)。 在61例患者中进行的74例操作中,39例患者的51例操作使用了SIF-Y0004,22例患者的23例操作使用了SIF-H290S。SIF-Y0004的操作成功率为70.6%,SIF-H290S的操作成功率为95.7%,表明新型短型SBE的结果更好(P = 0.02)。新型短型SBE的诊断成功率也更高(P = 0.047),到达盲端的中位时间更短(P < 0.001)。 使用新型短型SBE治疗的Roux-en-Y胃切除术患者的结局优于使用传统短型SBE治疗的患者。需要研究更多病例;然而,新型短型SBE有潜力改善解剖结构改变患者的ERCP结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3777/6264924/e2e5a18d4076/10-1055-a-0754-2290-i1245ei1.jpg

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