毕罗Ⅱ式重建术后内镜逆行胰胆管造影适合使用哪种内镜：食管胃十二指肠镜还是结肠镜？

Which scope is appropriate for endoscopic retrograde cholangiopancreatography after Billroth II reconstruction: An esophagogastroduodenoscope or a colonoscope?

作者信息

Sugimoto Mitsuru, Takagi Tadayuki, Suzuki Rei, Konno Naoki, Asama Hiroyuki, Sato Yuki, Irie Hiroki, Watanabe Ko, Nakamura Jun, Kikuchi Hitomi, Takasumi Mika, Hashimoto Minami, Kato Tsunetaka, Hikichi Takuto, Ohira Hiromasa

机构信息

Department of Gastroenterology, School of Medicine, Fukushima Medical University, Fukushima 9601247, Japan.

Department of Endoscopy, Fukushima Medical University Hospital, Fukushima 9601247, Japan.

出版信息

World J Gastrointest Endosc. 2020 Aug 16;12(8):220-230. doi: 10.4253/wjge.v12.i8.220.

DOI:10.4253/wjge.v12.i8.220

PMID:32879657

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7443825/

Abstract

BACKGROUND

Recently, with the advent of more advanced devices and endoscopic techniques, endoscopic retrograde cholangiopancreatography (ERCP) in Billroth II (B-II) patients has been increasingly performed. However, the procedures are difficult, and the techniques and strategies have not been defined.

AIM

To reveal the appropriate scope for ERCP in B-II patients.

METHODS

Sixty ERCP procedures were performed on B-II patients between June 2005 and May 2018 at Fukushima Medical University Hospital, and in 44 cases, this was the first ERCP procedure performed by esophagogastroduodenoscopy (EGDS) or colonoscopy (CS) after B-II gastrectomy. These cases were divided into two groups: 17 cases of ERCP performed by EGDS (EGDS group) and 27 cases of ERCP performed by CS (CS group). The patient characteristics and ERCP procedures were compared between the EGDS and CS groups.

RESULTS

The procedural time was significantly shorter in the EGDS group than in the CS group [median (range): 60 (20-100) 90 (40-128) min, value < 0.01]. CS was an independent factor of a longer ERCP procedural time according to the univariate and multivariate analyses (odds ratio: 3.97, 95%CI: 1.05-15.0, value = 0.04).

CONCLUSION

Compared to CS, EGDS shortened the procedural time of ERCP in B-II patients.

摘要

背景

近年来，随着更先进设备和内镜技术的出现，毕罗Ⅱ式（B-II）患者的内镜逆行胰胆管造影术（ERCP）开展得越来越多。然而，该操作难度较大，技术和策略尚未明确。

目的

揭示B-II患者行ERCP的合适范围。

方法

2005年6月至2018年5月期间，在福岛医科大学医院对B-II患者进行了60例ERCP操作，其中44例是B-II胃切除术后首次通过食管胃十二指肠镜检查（EGDS）或结肠镜检查（CS）进行的ERCP操作。这些病例分为两组：17例行EGDS引导下ERCP的病例（EGDS组）和27例行CS引导下ERCP的病例（CS组）。比较EGDS组和CS组的患者特征及ERCP操作情况。