Demarquay J F, Dumas R, Buckley M J, Conio M, Zanaldi H, Hastier P, Caroli-Bosc F X, Delmont J P
Dept. of Gastroenterology and Hepatology, Archet II University Hospital, Nice, France.
Ital J Gastroenterol Hepatol. 1998 Jun;30(3):297-300.
Endoscopic retrograde cholangiopacreatography and associated therapeutic procedures are widely used in routine clinical practice. The changes in the upper gastrointestinal anatomy after a Billroth II anastomosis may present technical difficulties at endoscopic retrograde cholangiopacreatography.
The case records of all patients who underwent endoscopic retrograde cholangiopacreatography at our Unit from January 1985 to December 1995 were reviewed. All patients who had had a previous Billroth II anastomosis or gastroenteroanastomosis were included in this analysis. Of the 5994 procedures performed, 124 patients with Billroth II surgery and 10 with a gastroenteroanastomosis were identified.
In these patients, the papilla was located in 89% of cases from 1985 to 1990 and in 100% of cases from 1991 to 1995. Overall, the success rates for pancreatography, cholangiography, and endoscopic sphincterotomy were 94%, 97.7%, and 100%, respectively. The morbidity and mortality rates were 7.4% and 0%, respectively.
The success rate for endoscopic retrograde cholangiopacreatography in patients with Billroth II gastrectomy is similar to that of a normal population.
内镜逆行胰胆管造影术及相关治疗操作在常规临床实践中被广泛应用。毕罗Ⅱ式吻合术后上消化道解剖结构的改变可能给内镜逆行胰胆管造影术带来技术困难。
回顾了1985年1月至1995年12月在本单位接受内镜逆行胰胆管造影术的所有患者的病例记录。所有曾接受过毕罗Ⅱ式吻合术或胃肠吻合术的患者均纳入本分析。在实施的5994例操作中，确定有124例接受毕罗Ⅱ式手术的患者和10例接受胃肠吻合术的患者。
在这些患者中，1985年至1990年期间89%的病例乳头位置可明确，1991年至1995年期间100%的病例乳头位置可明确。总体而言，胰管造影、胆管造影和内镜括约肌切开术的成功率分别为94%、97.7%和100%。发病率和死亡率分别为7.4%和0%。
毕罗Ⅱ式胃切除术后患者的内镜逆行胰胆管造影术成功率与正常人群相似。
