Escobedo-Paredes Daniel Martín, Hernández-Guerrero Angélica, Alonso-Lárraga J Octavio, Ramírez-Solís Mauro Eduardo, Jaurrieta-Rico César, Picazo-Ferrera Katia, González-Saucedo Angélica Melina, Aguilar-Moreno Raúl Uvaldo, Soc-Choz Pablo Geraldo
Endoscopia Gastrointestinal, Instituto Nacional de Cancerología, México.
Endoscopia Gastrointestinal, Instituto Nacional de Cancerología, MEXICO.
Rev Esp Enferm Dig. 2022 Mar;114(3):140-145. doi: 10.17235/reed.2021.7952/2021.
endoscopic evaluation of the ampulla of Vater (AV), although routinely recommended, is not always possible due to its anatomic configuration, which can hide it from the visual field of the forward-viewing endoscope. Cap-assisted forward-viewing endoscopy has been proposed as a useful alternative to facilitate the examination of this structure.
to assess the efficacy of cap-assisted forward-viewing endoscopy for the complete evaluation of the AV. Secondary outcomes were to assess AV morphology, search and total procedure times and technique safety.
a prospective, single-arm study. Patients who were selected for elective upper endoscopy were included. Patients with advanced neoplasia, modified anatomy, upper gastrointestinal stenosis or obstructions were excluded.
ninety patients were included, 36 males (40 %) and 54 females (60 %). Fifteen percent had a history of hereditary colon cancer syndrome. Technical success of cap-assisted, forward-viewing endoscopy was 98.8 %. AV was classified as type 1 (classic) in 49.4 %, type 2 (small) in 16.8 %, type 3 (protruding) in 11.2 % and type 4 (ridged) in 22.4 %. The mean search time was 37.7 seconds (s) (SD ± 31.6) and the total procedure time was 487.4 s (SD ± 206.2). No adverse events were reported.
cap-assisted forward-viewing endoscopy is an effective and safe technique for the complete visualization and morphologic characterization of the ampulla of Vater.
尽管常规推荐对十二指肠乳头（AV）进行内镜评估，但由于其解剖结构，有时无法进行评估，因为它可能会隐藏在前视内镜的视野之外。有人提出使用带帽前视内镜作为一种有用的替代方法，以方便对该结构进行检查。
评估带帽前视内镜对十二指肠乳头进行全面评估的有效性。次要结果是评估十二指肠乳头形态、寻找时间和总操作时间以及技术安全性。
一项前瞻性单臂研究。纳入因择期上消化道内镜检查而被选中的患者。排除患有晚期肿瘤、解剖结构改变、上消化道狭窄或梗阻的患者。
纳入90例患者，其中男性36例（40%），女性54例（60%）。15%的患者有遗传性结肠癌综合征病史。带帽前视内镜的技术成功率为98.8%。十二指肠乳头被分类为1型（经典型）的占49.4%，2型（小型）的占16.8%，3型（突出型）的占11.2%，4型（嵴型）的占22.4%。平均寻找时间为37.7秒（标准差±31.6），总操作时间为487.4秒（标准差±206.2）。未报告不良事件。
带帽前视内镜是一种有效且安全的技术，可用于十二指肠乳头的完整可视化和形态学特征分析。
