Department of Surgical Gastroenterology, Hospital South West Jutland, Region of Southern Denmark, Finsensgade 35, Skolebakken 141, 6705, Esbjerg, Denmark.
Department of Surgery, Odense University Hospital, J.B. Winsløws Vej 4, 5000, Odense, Denmark.
Obes Surg. 2024 Aug;34(8):2999-3004. doi: 10.1007/s11695-024-07268-4. Epub 2024 Jun 5.
The long-term need for biliary duct intervention following Roux-en-Y gastric bypass surgery (RYGB) is uncertain. We investigated the rate of laparoscopic assisted retrograde cholangiopancreatography (LAERCP) following RYGB. Also, the pre-LAERCP diagnostic workup together with the true rate of choledocholithiasis in patients with or without prior cholecystectomy was investigated.
Retrospective cohort study of RYGB and LAERCP performed at the Hospital South West Jutland, University Hospital of Southern Denmark, from 1 January 2013 to 31 May 2022.
One percent of patients (n = 13) with a history of RYGB (n = 1363) underwent LAERCP at our facility during a median follow-up of 60.6 months. The stone extraction rate was 66.7% in patients with in situ gallbladder and 12.5% in patients with prior cholecystectomy. Cannulation of the common bile duct was achieved in 96.7% of cases. Postoperative complications were observed in 22.6% of the cases.
Approximately 1% of RYGB patients needed LAERCP during a median follow-up of 5 years. In patients with a history of cholecystectomy, the LAERCP rate of stone extraction was very low (12.5%).
Roux-en-Y 胃旁路手术后（RYGB）长期胆道干预的需求尚不确定。我们调查了 RYGB 后腹腔镜辅助逆行胰胆管造影术（LAERCP）的发生率。此外，还调查了 LAERCP 术前诊断检查以及既往行胆囊切除术患者与未行胆囊切除术患者的胆总管结石的真实发生率。
对 2013 年 1 月 1 日至 2022 年 5 月 31 日在丹麦南丹麦大学医院西南医院行 RYGB 和 LAERCP 的患者进行回顾性队列研究。
在中位随访 60.6 个月期间，我院有 1%（n=13）的 RYGB 病史患者（n=1363）接受了 LAERCP。原位胆囊结石患者的取石率为 66.7%，既往行胆囊切除术患者的取石率为 12.5%。96.7%的病例均成功进行了胆总管插管。术后并发症发生率为 22.6%。
在中位随访 5 年期间，约 1%的 RYGB 患者需要 LAERCP。既往有胆囊切除术史的患者，LAERCP 取石率非常低（12.5%）。
