新型超薄双气囊内镜在小肠疾病诊断中的应用：一项多中心非随机研究。

Novel ultrathin double-balloon endoscopy for the diagnosis of small-bowel diseases: a multicenter nonrandomized study.

机构信息

Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan.

出版信息

Endoscopy. 2021 Aug;53(8):802-814. doi: 10.1055/a-1243-0226. Epub 2020 Sep 9.

DOI:10.1055/a-1243-0226

PMID:32906162

Abstract

BACKGROUND

This study aimed to compare the markers of potential pancreatic injury during antegrade double-balloon endoscopy (DBE) using the newly developed ultrathin EN-580XP system and the conventional EN-580T system.

METHODS

Patients who were scheduled for antegrade DBE during daily clinical practice were enrolled. Clinical background, adverse events, and laboratory data of patients were compared between those who underwent endoscopy using the EN-580XP system and those in whom the EN-580T system was used. The primary end points were pancreatic hyperamylasemia and hyperlipasemia after DBE.

RESULTS

A total of 295 cases were registered. Pancreatic hyperamylasemia occurred in 2 of 92 patients (2.2 %) in the EN-580XP group and in 28 of 147 patients (19.1 %) in the EN-580 T diagnosis group ( < 0.001). Hyperlipasemia was significantly different between the two groups (1.1 % [EN-580XP] vs. 13.6 % [EN-580 T diagnosis]; < 0.001). Acute pancreatitis occurred in four patients (7.1 %) in the EN-580 T therapy group. Multiple logistic regression analyses revealed that the endoscope type EN-580 T was significantly associated with pancreatic hyperamylasemia (adjusted odds ratio [OR] 8.63, 95 % confidence interval [CI] 1.97 - 37.70; < 0.01) and hyperlipasemia (adjusted OR 13.10, 95 %CI 1.70 - 100.70; = 0.01).

CONCLUSIONS

The EN-580XP system seemed less harmful to the pancreas during antegrade DBE.

摘要

背景

本研究旨在比较使用新型超薄 EN-580XP 系统和传统 EN-580T 系统进行逆行双球囊内镜检查（DBE）时潜在胰腺损伤的标志物。

方法

纳入在日常临床实践中接受逆行 DBE 的患者。比较使用 EN-580XP 系统进行内镜检查的患者和使用 EN-580T 系统的患者的临床背景、不良事件和实验室数据。主要终点是 DBE 后胰淀粉酶和脂肪酶升高。

结果

共登记了 295 例患者。EN-580XP 组 92 例患者中有 2 例（2.2%）发生胰淀粉酶升高，EN-580T 诊断组 147 例患者中有 28 例（19.1%）发生胰淀粉酶升高（ < 0.001）。两组间脂肪酶升高差异有统计学意义（1.1%[EN-580XP]比 13.6%[EN-580T 诊断]； < 0.001）。EN-580T 治疗组有 4 例（7.1%）发生急性胰腺炎。多因素 logistic 回归分析显示，内镜类型 EN-580T 与胰淀粉酶升高（调整优势比[OR]8.63，95%可信区间[CI]1.97-37.70； < 0.01）和脂肪酶升高（调整 OR 13.10，95%CI 1.70-100.70； = 0.01）显著相关。