经内镜逆行胰胆管造影术的若干进展

王向平; 潘阳林; 郭学刚

doi:10.3969/j.issn.1001-5256.2018.03.004

经内镜逆行胰胆管造影术的若干进展

DOI: 10.3969/j.issn.1001-5256.2018.03.004

空军军医大学第一附属医院西京消化病医院

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出版历程
- 出版日期: 2018-03-20

Advances in endoscopic retrograde cholangiopancreatography

Xijing Hospital of Digestive Disease, The First Affiliated Hospital of Fourth Military Medical University

摘要

摘要:
作为一项成熟应用于胆胰疾病的高级内镜诊疗技术,经内镜逆行胰胆管造影(ERCP)近几年来在治疗理念和技术方面有了一些新的发展。对ERCP的若干进展进行了阐述,主要包括:运用胰管支架、非甾体抗炎类药物及大量水化预防术后胰腺炎,覆膜金属支架用于治疗良性胆管狭窄,恶性胆管狭窄的腔内射频消融治疗,体外冲击波碎石术和覆膜金属支架治疗慢性胰腺炎,经口胆道镜应用于胆管狭窄定性诊断和巨大难治性结石,困难插管的定义和预切开技术的时机以及胃肠道重建术后ERCP。
- 胰胆管造影术,内窥镜逆行 /
- 经口胆管镜 /
- 胆管括约肌预切 /
- 胰腺炎 /
- 胆管狭窄
Abstract:
Endoscopic retrograde cholangiopancreatography ( ERCP) is a well-established advanced endoscopic technique for the diagnosis and treatment of pancreatobiliary diseases. New advances have been made in the treatment concept and techniques of ERCP in recent years.This article elaborates on the recent advances in ERCP, including the application of pancreatic duct stent, non-steroidal anti-inflammatory drugs, and aggressive hydration to prevent postoperative pancreatitis, covered metal stent for the treatment of benign bile duct stenosis, intraluminal radiofrequency ablation for malignant bile duct stenosis, extracorporeal shockwave lithotripsy and covered metal stent for the treatment of chronic pancreatitis, peroral choledochoscopy for qualitative diagnosis of bile duct stenosis and huge refractory stones, definition of difficult intubation, timing of pre-cut technique, and ERCP after gastrointestinal reconstruction.
- cholangiopancreatography, endoscopic retrograde /
- per-oral cholangioscopy /
- precut sphincterotomy /
- pancreatitis /
- biliary stricture

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参考文献(72)

[1]HU LH, XIN L, LIAO Z, et al.ERCP development in the largest developing country:a national survey from China in 2013[J].Gastrointest Endosc, 2016, 84 (4) :659-666.

[2]KOCHAR B, AKSHINTALA VS, AFGHANI E, et al.Incidence, severity, and mortality of post-ERCP pancreatitis:a systematic review by using randomized, controlled trials[J].Gastrointest Endosc, 2015, 81 (1) :143-149.

[3]FREEMAN ML, DISARIO JA, NELSON DB, et al.Risk factors for post-ERCP pancreatitis:a prospective, multicenter study[J].Gastrointest Endosc, 2001, 54 (4) :425-434.

[4]CHA SW, LEUNG WD, LEHMAN GA, et al.Does leaving a main pancreatic duct stent in place reduce the incidence of precut biliary sphincterotomy-associated pancreatitis?A randomized, prospective study[J].Gastrointest Endosc, 2013, 77 (2) :209-216.

[5]ARAIN MA, FREEMAN ML.Pharmacologic prophylaxis alone is not adequate to prevent post-ERCP pancreatitis[J].Am J Gastroenterol, 2014, 109 (6) :910-912.

[6]MAZAKI T, MADO K, MASUDA H, et al.Prophylactic pancreatic stent placement and post-ERCP pancreatitis:an updated meta-analysis[J].J Gastroenterol, 2014, 49 (2) :343-355.

[7]CHOUDHARY A, BECHTOLD ML, ARIF M, et al.Pancreatic stents for prophylaxis against post-ERCP pancreatitis:a meta-analysis and systematic review[J].Gastrointest Endosc, 2011, 73 (2) :275-282.

[8]DUMONCEAU JM, ANDRIULLI A, ELMUNZER BJ, et al.Prophylaxis of post-ERCP pancreatitis:European Society of Gastrointestinal Endoscopy (ESGE) Guideline-updated June 2014[J].Endoscopy, 2014, 46 (9) :799-815.

[9]AFGHANI E, AKSHINTALA VS, KHASHAB MA, et al.5-Fr vs.3-Fr pancreatic stents for the prevention of post-ERCP pancreatitis in high-risk patients:a systematic review and network meta-analysis[J].Endoscopy, 2014, 46 (7) :173-180.

[10]CHOKSI NS, FOGEL EL, COTE GA, et al.The risk of post-ERCP pancreatitis and the protective effect of rectal indomethacin in cases of attempted but unsuccessful prophylactic pancreatic stent placement[J].Gastrointest Endosc, 2015, 81 (1) :150-155.

[11]ELMUNZER BJ, SCHEIMAN JM, LEHMAN GA, et al.A randomized trial of rectal indomethacin to prevent post-ERCP pancreatitis[J].N Engl J Med, 2012, 366 (15) :1414-1422.

[12]SOTOUDEHMANESH R, KHATIBIAN M, KOLAHDOOZAN S, et al.Indomethacin may reduce the incidence and severity of acute pancreatitis after ERCP[J].Am J Gastroenterol, 2007, 102 (5) :978-983.

[13]OTSUKA T, KAWAZOE S, NAKASHITA S, et al.Low-dose rectal diclofenac for prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis:a randomized controlled trial[J].J Gastroenterol, 2012, 47 (8) :912-917.

[14]DING X, CHEN M, HUANG S, et al.Nonsteroidal anti-inflammatory drugs for prevention of post-ERCP pancreatitis:a meta-analysis[J].Gastrointest Endosc, 2012, 76 (6) :1152-1159.

[15]YAGHOOBI M, ROLLAND S, WASCHKE KA, et al.Meta-analysis:rectal indomethacin for the prevention of post-ERCP pancreatitis[J].Aliment Pharmacol Ther, 2013, 38 (9) :995-1001.

[16]SUN HL, HAN B, ZHAI HP, et al.Rectal NSAIDs for the prevention of post-ERCP pancreatitis:a meta-analysis of randomized controlled trials[J].Surgeon, 2014, 12 (3) :141-147.

[17]YUHARA H, OGAWA M, KAWAGUCHI Y, et al.Pharmacologic prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis:protease inhibitors and NSAIDs in a meta-analysis[J].J Gastroenterol, 2014, 49 (3) :388-399.

[18]LEVENICK JM, GORDON SR, FADDEN LL, et al.Rectal indomethacin does not prevent post-ERCP pancreatitis in consecutive patients, a randomized trial[J].Gastroenterology, 2016, 150 (4) :911-917.

[19]LUO H, ZHAO L, LEUNG J, et al.Routine pre-procedural rectal indomethacin versus selective post-procedural rectal indomethacin to prevent pancreatitis in patients undergoing endoscopic retrograde cholangiopancreatography:a multicentre, single-blinded, randomised controlled trial[J].Lancet, 2016, 387:2293-2301.

[20]BUXBAUM J, YAN A, YEH K, et al.Aggressive hydration with lactated ringer's solution reduces pancreatitis after endoscopic retrograde cholangiopancreatography[J].Clin Gastroenterol Hepatol, 2014, 12 (2) :303-307.

[21]CHOI JH, KIM HJ, LEE BU, et al.Vigorous periprocedural hydration with lactated ringer's solution reduces the risk of pancreatitis after retrograde cholangiopancreatography in hospitalized patients[J].Clin Gastroenterol Hepatol, 2017, 15 (1) :86-92.

[22]MOK SRS, HO HC, SHAH P, et al.Lactated Ringer's solution in combination with rectal indomethacin for prevention of post-ERCP pancreatitis and readmission:a prospective randomized, doubleblinded, placebo-controlled trial[J].Gastrointest Endosc, 2017, 85 (5) :1005-1013.

[23]SHAYGAN-NEJAD A, MASJEDIZADEH AR, GHAVIDEL A, et al.Aggressive hydration with Lactated Ringer's solution as the prophylactic intervention for postendoscopic retrograde cholangiopancreatography pancreatitis:a randomized controlled double-blind clinical trial[J].J Res Med Sci, 2015, 20 (9) :838-843.

[24]HU B, SUN B, CAI Q, et al.Asia-Pacific consensus guidelines for endoscopic management of benign biliary strictures[J].Gastrointest Endosc, 2017, 86 (1) :44-58.

[25]COTEGA, SLIVKA A, TARNASKY P, et al.Effect of covered metallic stents compared with plastic stents on benign biliary stricture resolution:a randomized clinical trial[J].JAMA, 2016, 315 (12) :1250-1257.

[26]HAAPAMAKI C, KYLANPAAL, UDD M, et al.Randomized multicenter study of multiple plastic stents vs.covered self-expandable metallic stent in the treatment of biliary stricture in chronic pancreatitis[J].Endoscopy, 2015, 47 (7) :605-610.

[27]ARTIFON EL, COELHO F, FRAZAO M, et al.A prospective randomized study comparing partially covered metal stent versus plastic multistent in the endoscopic management of patients with postoperative benign bile duct strictures:a follow-up above 5 years[J].Rev Gastroenterol Peru, 2012, 32 (1) :26-31.

[28]KAFFES A, GRIFFIN S, VAUGHAN R, et al.A randomized trial of a fully covered self-expandable metallic stent versus plastic stents in anastomotic biliary strictures after liver transplantation[J].Therap Adv Gastroenterol, 2014, 7 (2) :64-71.

[29]KHAN MA, BARON TH, KAMAL F, et al.Efficacy of self-expandable metal stents in management of benign biliary strictures and comparison with multiple plastic stents:a meta-analysis[J].Endoscopy, 2017, 49 (7) :682-694.

[30]WALTER D, LALEMAN W, JANSEN JM, et al.A fully covered self-expandable metal stent with antimigration features for benign biliary strictures:a prospective, multicenter cohort study[J].Gastrointest Endosc, 2015, 81 (5) :1197-1203.

[31]MOON JH, CHOI HJ, KOO HC, et al.Feasibility of placing a modified fully covered self-expandable metal stent above the papilla to minimize stent-induced bile duct injury in patients with refractory benign biliary strictures[J].Gastrointest Endosc, 2012, 75 (5) :1080-1085.

[32]LALEMAN W, van der MERWE S, VERBEKE L, et al.A new intraductal radiofrequency ablation device for inoperable biliopancreatic tumors complicated by obstructive jaundice:the IGNITE-1 study[J].Endoscopy, 2017, 49 (10) :977-982.

[33]STRAND DS, COSGROVE ND, PATRIE JT, et al.ERCP-directed radiofrequency ablation and photodynamic therapy are associated with comparable survival in the treatment of unresectable cholangiocarcinoma[J].Gastrointest Endosc, 2014, 80 (5) :794-804.

[34]KALLIS Y, PHILLIPS N, STEEL A, et al.Analysis of endoscopic radiofrequency ablation of biliary malignant strictures in pancreatic cancer suggests potential survival benefit[J].Dig Dis Sci, 2015, 60 (11) :3449-3455.

[35]SHARAIHA RZ, SETHI A, WEAVER KR, et al.Impact of radiofrequency ablation on malignant biliary strictures:results of a collaborative registry[J].Dig Dis Sci, 2015, 60 (7) :2164-2169.

[36]KADAYIFCI A, ATAR M, FORCIONE DG, et al.Radiofrequency ablation for the management of occluded biliary metal stents[J].Endoscopy, 2016, 48 (12) :1096-1101.

[37]SOFI AA, KHAN MA, DAS A, et al.Radiofrequency ablation combined with biliary stent placement versus stent placement alone for malignant biliary strictures:a systematic review and meta-analysis[J].Gastrointest Endosc, 2017.[Epub ahead of print]

[38]RUSTAGI T, IRANI S, REDDY DN, et al.Radiofrequency ablation for intraductal extension of ampullary neoplasms[J].Gastrointest Endosc, 2017, 86 (1) :170-176.

[39]CLARK CJ, FINO NF, CLARK N, et al.Trends in the use of endoscopic retrograde cholangiopancreatography for the management of chronic pancreatitis in the United States[J].J Clin Gastroenterol, 2016, 50 (5) :417-422.

[40]HU LH, YE B, YANG YG, et al.Extracorporeal shock wave lithotripsy for Chinese patients with pancreatic stones:a prospective study of 214 cases[J].Pancreas, 2016, 45 (2) :298-305.

[41]LI BR, LIAO Z, DU TT, et al.Extracorporeal shock wave lithotripsy is a safe and effective treatment for pancreatic stones coexisting with pancreatic pseudocysts[J].Gastrointest Endosc, 2016, 84 (1) :69-78.

[42]LAPP RT, WOLF JS Jr, FAERBER GJ, et al.Duct diameter and size of stones predict successful extracorporeal shock wave lithotripsy and endoscopic clearance in patients with chronic pancreatitis and pancreaticolithiasis[J].Pancreas, 2016, 45 (8) :1208-1211.

[43]OGURA T, ONDA S, TAKAGI W, et al.Placement of a 6 mm, fully covered metal stent for main pancreatic head duct stricture due to chronic pancreatitis:a pilot study (with video) [J].Therap Adv Gastroenterol, 2016, 9 (5) :722-728.

[44]CAHEN DL, van der MERWE SW, LALEMAN W, et al.A biodegradable non-covered self-expandable stent to treat pancreatic duct strictures in chronic pancreatitis:a proof of principle[J].Gastrointest Endosc, 2017.[Epub ahead of print]

[45]TRINGALI A, LEMMERS A, MEVES V, et al.Intraductal biliopancreatic imaging:European Society of Gastrointestinal Endoscopy (ESGE) technology review[J].Endoscopy, 2015, 47 (8) :739-753.

[46]SHAH RJ, RAIJMAN I, BRAUER B, et al.Performance of a fully disposable, digital, single-operator cholangiopancreatoscope[J].Endoscopy, 2017, 49 (7) :651-658.

[47]NAVANEETHAN U, HASAN MK, LOURDUSAMY V, et al.Single-operator cholangioscopy and targeted biopsies in the diagnosis of indeterminate biliary strictures:a systematic review[J].Gastrointest Endosc, 2015, 82 (4) :608-614.

[48]NAVANEETHAN U, HASAN MK, KOMMARAJU K, et al.Digital, single-operator cholangiopancreatoscopy in the diagnosis and management of pancreatobiliary disorders:a multicenter clinical experience (with video) [J].Gastrointest Endosc, 2016, 84 (4) :649-655.

[49]VARADARAJULU S, BANG JY, HASAN MK, et al.Improving the diagnostic yield of single-operator cholangioscopy-guided biopsy of indeterminate biliary strictures:ROSE to the rescue? (with video) [J].Gastrointest Endosc, 2016, 84 (4) :681-687.

[50]MOUNZER R, AUSTIN GL, WANI S, et al.Per-oral video cholangiopancreatoscopy with narrow-band imaging for the evaluation of indeterminate pancreaticobiliary disease[J].Gastrointest Endosc, 2017, 85 (3) :509-517.

[51]LALEMAN W, VERRAES K, VAN STEENBERGEN W, et al.Usefulness of the single-operator cholangioscopy system Spy Glass in biliary disease:a single-center prospective cohort study and aggregated review[J].Surg Endosc, 2017, 31 (5) :2223-2232.

[52]BREWER GUTIERREZ OI, BEKKALI NLH, RAIJMAN I, et al.Efficacy and safety of digital single-operator cholangioscopy for difficult biliary stones[J].Clin Gastroenterol Hepatol, 2017.[Epub ahead of print]

[53]BHANDARI S, BATHINI R, SHARMA A, et al.Usefulness of single-operator cholangioscopy-guided laser lithotripsy in patients with Mirizzi syndrome and cystic duct stones:experience at a tertiary care center[J].Gastrointest Endosc, 2016, 84 (1) :56-61.

[54]BUXBAUM J, SAHAKIAN A, KO C, et al.Randomized trial of cholangioscopy-guided laser lithotripsy versus conventional therapy for large bile duct stones (with videos) [J].Gastrointest Endosc, 2017.[Epub ahead of print]

[55]DEPREZ PH, GARCES DURAN R, MOREELS T, et al.The economic impact of using single-operator cholangioscopy for the treatment of difficult bile duct stones and diagnosis of indeterminate bile duct strictures[J].Endoscopy, 2017.[Epub ahead of print]

[56]TESTONI PA, MARIANI A, AABAKKEN L, et al.Papillary cannulation and sphincterotomy techniques at ERCP:European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline[J].Endoscopy, 2016, 48 (7) :657-683.

[57]LIAO WC, ANGSUWATCHARAKON P, ISAYAMA H, et al.International consensus recommendations for difficult biliary access[J].Gastrointest Endosc, 2017, 85 (2) :295-304.

[58]PECSI D, FARKAS N, HEGYI P, et al.Transpancreatic sphincterotomy has a higher cannulation success rate than needle-knife precut papillotomy-a meta-analysis[J].Endoscopy, 2017, 49 (9) :874-887.

[59] SUGIYAMA H, TSUYUGUCHI T, SAKAI Y, et al.Transpancreatic precut papillotomy versus double-guidewire technique in difficult biliary cannulation:prospective randomized study[J].Endoscopy, 2018, 50 (1) :33-39.

[60]MARIANI A, DI LEO M, GIARDULLO N, et al.Early precut sphincterotomy for difficult biliary access to reduce post-ERCP pancreatitis:a randomized trial[J].Endoscopy, 2016, 48 (6) :530-535.

[61]JIN YJ, JEONG S, LEE DH.Utility of needle-knife fistulotomy as an initial method of biliary cannulation to prevent post-ERCP pancreatitis in a highly selected at-risk group:a single-arm prospective feasibility study[J].Gastrointest Endosc, 2016, 84 (5) :808-813.

[62]KIM MH, LEE SK, LEE MH, et al.Endoscopic retrograde cholangiopancreatography and needle-knife sphincterotomy in patients with Billroth II gastrectomy:a comparative study of the forwardviewing endoscope and the side-viewing duodenoscope[J].Endoscopy, 1997, 29 (2) :82-85.

[63]BOVE V, TRINGALI A, FAMILIARI P, et al.ERCP in patients with prior Billroth II gastrectomy:report of 30 years'experience[J].Endoscopy, 2015, 47 (7) :611-616.

[64]WU WG, MEI JW, ZHAO MN, et al.Use of the conventional side-viewing duodenoscope for successful endoscopic retrograde cholangiopancreatography in postgastrectomy patients[J].J Clin Gastroenterol, 2016, 50 (3) :244-251.

[65]PARK TY, KANG JS, SONG TJ, et al.Outcomes of ERCP in Billroth II gastrectomy patients[J].Gastrointest Endosc, 2016, 83 (6) :1193-1201.

[66]JANG HW, LEE KJ, JUNG MJ, et al.Endoscopic papillary large balloon dilatation alone is safe and effective for the treatment of difficult choledocholithiasis in cases of Billroth II gastrectomy:a single center experience[J].Dig Dis Sci, 2013, 58 (6) :1737-1743.

[67]LEE TH, HWANG JC, CHOI HJ, et al.One-step transpapillary balloon dilation under cap-fitted endoscopy without a preceding sphincterotomy for the removal of bile duct stones in Billroth II gastrectomy[J].Gut Liver, 2012, 6 (1) :113-117.

[68]CHOI CW, CHOI JS, KANG DH, et al.Endoscopic papillary large balloon dilation in Billroth II gastrectomy patients with bile duct stones[J].J Gastroenterol Hepatol, 2012, 27 (2) :256-260.

[69]SHAH RJ, SMOLKIN M, YEN R, et al.A multicenter, US experience of single-balloon, double-balloon, and rotational overtube-assisted enteroscopy ERCP in patients with surgically altered pancreaticobiliary anatomy (with video) [J].Gastrointest Endosc, 2013, 77 (4) :593-600.

[70]SKINNER M, POPA D, NEUMANN H, et al.ERCP with the overtube-assisted enteroscopy technique:a systematic review[J].Endoscopy, 2014, 46 (7) :560-572.

[71]SHIMATANI M, HATANAKA H, KOGURE H, et al.Diagnostic and therapeutic endoscopic retrograde cholangiography using a short-type double-balloon endoscope in patients with altered gastrointestinal anatomy:a multicenter prospective study in Japan[J].Am J Gastroenterol, 2016, 111 (12) :1750-1758.

[72]REES CJ, NGU WS, REGULA J, et al.European Society of Gastrointestinal Endoscopy-Establishing the key unanswered research questions within gastrointestinal endoscopy[J].Endoscopy, 2016, 48 (10) :884-891.

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