Buchholz Hendrik, Mende Matthias, Hornoff Steffen, Faiss Siegbert
Gastroenterology, Sana Klinikum Lichtenberg, Berlin, Germany.
Z Gastroenterol. 2022 Nov;60(11):1635-1643. doi: 10.1055/a-1744-6738. Epub 2022 Feb 17.
For motorized spiral enteroscopy, only limited data are available. We report about our early experiences with the motorized spiral enteroscopy in a retrospective case series. The present worldwide study reported the results of motorized spiral enteroscopy in 68 patients with small bowel diseases and in 15 patients with ERCP and surgically altered anatomy.
This retrospective single-centre study was performed between 01/2020 and 09/2021 in 83 consecutive patients. Indications were known or suspected small bowel diseases or diseases of the bile or pancreatic duct after surgical altered anatomy with Roux-Y anastomosis.
In 68 patients (38 m/30 f; mean age 66.4 years) with an indication for small bowel enteroscopy, diagnostic and therapeutic yield was 86.8% and 41.2%, respectfully. The average depth of maximum insertion was 279 cm with an average insertion time of 64.3 min. In 13 patients (19.7%), complete panenteroscopy was achieved. In patients without prior abdominal surgery, the rate of complete enteroscopy was 46.2%.In 15 patients (9 m; 6 f; mean age 61.8 years) with surgically altered anatomy and Roux-Y anastomosis (the papilla resp.), the biliodigestive anastomosis could be reached in 60%.In the entire case series, the total complication rate was 15.7%. There were no severe complications, such as perforation or major bleeding.
The present case series shows a high rate of panenteroscopies with a short examination time. To confirm these data, further comparative studies for ERCPs in patients with surgically altered anatomy are necessary.
关于电动螺旋式小肠镜检查,目前仅有有限的数据。我们在一项回顾性病例系列研究中报告了我们使用电动螺旋式小肠镜检查的早期经验。目前这项全球范围的研究报告了68例小肠疾病患者以及15例接受过内镜逆行胰胆管造影术(ERCP)且解剖结构经手术改变的患者接受电动螺旋式小肠镜检查的结果。
这项回顾性单中心研究于2020年1月至2021年9月期间对83例连续患者进行。适应证为已知或疑似小肠疾病,或在进行Roux-Y吻合术的手术改变解剖结构后出现的胆管或胰管疾病。
在68例有小肠镜检查适应证的患者中(38例男性/30例女性;平均年龄66.4岁),诊断和治疗成功率分别为86.8%和41.2%。最大插入深度平均为279厘米,平均插入时间为64.3分钟。13例患者(19.7%)完成了全小肠镜检查。在未接受过腹部手术的患者中,全小肠镜检查率为46.2%。在15例解剖结构经手术改变且有Roux-Y吻合术(乳头相关)的患者中(9例男性;6例女性;平均年龄61.8岁),60%的患者能够到达胆肠吻合口。在整个病例系列中,总并发症发生率为15.7%。没有发生穿孔或大出血等严重并发症。
本病例系列显示全小肠镜检查率高且检查时间短。为了证实这些数据,有必要对解剖结构经手术改变的患者进行进一步的ERCP对比研究。