Siegel J H
Endoscopy. 1982 Nov;14(6):238-40. doi: 10.1055/s-2007-1021630.
The sump syndrome has been reported to occur infrequently following a choledochoenterostomy (duodenostomy or jejunostomy) for stone disease. The enterostomy stoma usually decreases in diameter following surgery allowing for reflux into the distal, inactive segment of the bile duct without adequate egress of the material. This stagnant portion of the bile duct functions as a reservoir for collection of debris and/or lithogenic bile resulting in intermittent obstruction of the stoma producing symptoms of pain and clinical and biochemical evidence of cholestasis and pancreatitis. This symptom complex has been labelled as the sump syndrome and has been effectively diagnosed by endoscopic retrograde cholangiopancreatography (ERCP) and treated by duodenoscopic sphincterotomy. Occasionally the enterostomy stoma remains adequate but foreign material or debris aggregates to produce obstruction. The case described in this report matched the latter description and was diagnosed by a new endoscopic application, peroral choledochoscopy. This new technique and the recommendations for evaluation and treatment of the sump syndrome as well as alternate surgical techniques to avoid its occurrence will be discussed.
据报道，胆总管结石病行胆总管肠吻合术（十二指肠吻合术或空肠吻合术）后，贮袋综合征很少发生。术后肠造口直径通常会减小，导致胆汁反流至远端无功能的胆管节段，且物质无法充分排出。胆管的这一停滞部分起到了收集碎片和/或致石性胆汁的贮器作用，导致造口间歇性梗阻，产生疼痛症状以及胆汁淤积和胰腺炎的临床及生化证据。这种症状复合体被称为贮袋综合征，通过内镜逆行胰胆管造影（ERCP）可有效诊断，并通过十二指肠镜括约肌切开术进行治疗。偶尔，肠造口足够，但异物或碎片聚集导致梗阻。本报告中描述的病例符合后一种情况，并通过一种新的内镜应用——经口胆管镜检查得以诊断。本文将讨论这项新技术、贮袋综合征的评估和治疗建议以及避免其发生的替代手术技术。
