双气囊内镜逆行胰胆管造影术在肝手术后患者中的应用：一项回顾性研究。
Double-balloon endoscopic retrograde cholangiopancreatography for patients who underwent liver operation: A retrospective study.
机构信息
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Aichi Prefecture, Nagoya 4668550, Japan.
Department of Endoscopy, Nagoya University Hospital, Aichi Prefecture, Nagoya 4668550, Japan.
出版信息
World J Gastroenterol. 2020 Mar 14;26(10):1056-1066. doi: 10.3748/wjg.v26.i10.1056.
BACKGROUND
Double-balloon endoscopic retrograde cholangiography (DB-ERC) is widely performed for biliary diseases after reconstruction in gastrointestinal surgery, but there are few reports on DB-ERC after hepatectomy or living donor liver transplantation (LDLT).
AIM
To examine the success rates and safety of DB-ERC after hepatectomy or LDLT.
METHODS
The study was performed retrospectively in 26 patients (45 procedures) who underwent hepatectomy or LDLT (liver operation: LO group) and 40 control patients (59 procedures) who underwent pancreatoduodenectomy (control group). The technical success (endoscope reaching the choledochojejunostomy site), diagnostic success (performance of cholangiography), therapeutic success (completed interventions) and overall success rates, insertion and procedure (completion of DB-ERC) time, and adverse events were compared between these groups.
RESULTS
There were no significant differences between LO and control groups in the technical [93.3% (42/45) 96.6% (57/59), = 0.439], diagnostic [83.3% (35/42) 83.6% (46/55), = 0.968], therapeutic [97.0% (32/33) 97.7% (43/44), = 0.836], and overall [75.6% (34/45) 79.7% (47/59), = 0.617] success rates. The median insertion time (22 14 min, < 0.001) and procedure time (43.5 30 min, = 0.033) were significantly longer in the LO group. The incidence of adverse events showed no significant difference [11.1% (5/45) 6.8% (4/59), = 0.670].
CONCLUSION
DB-ERC after liver operation is safe and useful but longer time is required, so should be performed with particular care.
背景
双球囊内镜逆行胆管造影术（DB-ERC）广泛应用于胃肠手术后胆道疾病的治疗，但关于肝切除或活体肝移植（LDLT）后行 DB-ERC 的报道较少。
目的
探讨肝切除或 LDLT 后行 DB-ERC 的成功率和安全性。
方法
本研究回顾性分析了 26 例（45 例次）肝切除或 LDLT 患者（肝手术组，LO 组）和 40 例接受胰十二指肠切除术患者（对照组）的临床资料。比较两组间技术成功率（内镜到达胆肠吻合口）、诊断成功率（完成胆管造影）、治疗成功率（完成介入操作）和总体成功率、插入和操作（完成 DB-ERC）时间以及不良事件。
结果
LO 组和对照组的技术成功率[93.3%（42/45）比 96.6%（57/59）， = 0.439]、诊断成功率[83.3%（35/42）比 83.6%（46/55）， = 0.968]、治疗成功率[97.0%（32/33）比 97.7%（43/44）， = 0.836]和总体成功率[75.6%（34/45）比 79.7%（47/59）， = 0.617]差异均无统计学意义。LO 组的中位插入时间（22 14 min， ＜0.001）和操作时间（43.5 30 min， = 0.033）显著长于对照组。两组不良事件发生率差异无统计学意义[11.1%（5/45）比 6.8%（4/59）， = 0.670]。
结论
肝手术后行 DB-ERC 安全、有效，但操作时间较长，应特别谨慎。
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