Mangiavillano Benedetto, Carrara Silvia, Eusebi Leonardo H, Auriemma Franceasco, Bianchetti Mario, Repici Alessandro
Gastrointestinal Endoscopy Unit - Humanitas Mater Domini - Castellanza, Italy.
Humanitas University, Rozzano, Italy.
Endosc Int Open. 2021 Mar;9(3):E487-E489. doi: 10.1055/a-1339-0690. Epub 2021 Feb 22.
One of the main challenges encountered by endosonographers is performing diagnostic and interventional pancreato-biliary endoscopic ultrasound (EUS) procedures in the presence of surgically altered upper gastrointestinal anatomy. We describe the water-filled technique (WFT) for EUS examination and treatment of the pancreato-biliary region in patients with surgically altered upper gastrointestinal anatomy. Using the WFT, the scope is advanced up to the gastro-jejunal anastomosis and, after placing the tip of the scope 2 cm beyond it, enlargement of the jejunal lumen is obtained by water instillation of the jejunal loop. An enlargement of more than 1.5 cm allows advancement of the tip of the scope under EUSguidance up to the duodenum, in a retrograde way. The WFT is useful for reaching the ampullary area and performing diagnostic and therapeutic EUS in patients with surgically altered anatomy. The technique is also reproducible and can be easily used by endoscopists who regularly perform EUS.
内镜超声检查医师面临的主要挑战之一是，在存在外科手术改变的上消化道解剖结构的情况下，进行诊断性和介入性胰胆内镜超声（EUS）操作。我们描述了一种用于对具有外科手术改变的上消化道解剖结构的患者进行胰胆区域EUS检查和治疗的水充盈技术（WFT）。使用WFT时，将内镜推进至胃空肠吻合口，在将内镜尖端置于吻合口以外2厘米处后，通过向空肠袢内注入水来扩大空肠腔。空肠腔扩大超过1.5厘米时，可在EUS引导下将内镜尖端逆行推进至十二指肠。WFT有助于到达壶腹区域，并对具有外科手术改变的解剖结构的患者进行诊断性和治疗性EUS。该技术具有可重复性，并且经常进行EUS的内镜医师可以轻松使用。
