中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 3
Mar.  2018
Turn off MathJax
Article Contents

Clinical effect of balloon-assisted enteroscopy combined with endoscopic retrograde cholangiopancreatography in patients with altered gastrointestinal anatomy

DOI: 10.3969/j.issn.1001-5256.2018.03.019
Research funding:

 

  • Published Date: 2018-03-20
  • Objective To investigate the clinical effect and safety of balloon-assisted enteroscopy combined with endoscopic retrograde cholangiopancreatography ( ERCP) in patients with altered gastrointestinal anatomy. Methods A total of 12 patients who were admitted to General Hospital of Beijing Military Region from April 2016 to October 2017 and underwent balloon-assisted ERCP after surgical alteration of gastrointestinal anatomy were enrolled, among whom 4 underwent choledochoenterostomy and 8 underwent pancreaticoduodenectomy.Double-balloon enteroscopy was performed for 4 patients and single-balloon enteroscopy was performed for 8 patients. A retrospective analysis was performed for treatment outcome, complications, and prognosis. Results A total of 10 patients underwent balloon-assisted ERCP successfully, resulting in an overall success rate of 83. 3%, and among these patients, 2 had simple anastomotic stenosis and 8 had anastomotic stenosis and intrahepatic bile duct stones. Among the two patients who did not complete ERCP, one had severe anastomotic stenosis which prevented the guide wire from entering the bile duct, and the other patient had a small angle of R-Y intestinal anastomosis which prevented the lens and the cannula from entering the afferent loop. After surgery, one patient experienced jaundice and one experienced perforation of the gastrointestinal tract, resulting in an incidence rate of complications of 16. 7%, and both patients were cured after conservative treatment. Conclusion Balloon-assisted ERCP has good safety and a marked clinical effect with unique complications, as well as a lower success rate than conventional ERCP.

     

  • loading
  • [1]HARUTA H, YAMAMOTO H, MIZUTA K, et al.A case of successful enteroscopic balloon dilation for late anastomotic stricture of choledochojejunostomy after living donor liver transplantation[J].Liver Transpl, 2005, 11 (12) :1608-1610.
    [2]NEUMANN H, FRY LC, MEYER F, et al.Endoscopic retrograde cholangiopancreatography using the single balloon enteroscope technique in patients with Roux-en-Y anastomosis[J].Digestion, 2009, 80 (1) :52-57.
    [3]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.
    [4]LI K, HUANG YH, YAO W, et al.Balloon-assisted enteroscopy for biliary and pancreatic diseases after complex gastrointestinal surgery[J].Chin J Dig Endosc, 2012, 29 (7) :393-396. (in Chinese) 李柯, 黄永辉, 姚炜, 等.气囊辅助内镜技术诊治消化道复杂手术后胰胆疾病的初步探索[J].中华消化内镜杂志, 2012, 29 (7) :393-396.
    [5]MEI JW, ZHANG Y, ZHANG WJ, et al.Diagnostic and therapeutic endoscopy for biliary stones following bilioenterostomy:a report of 17 patients[J].Chin J Pract Surg, 2014, 34 (10) :953-956. (in Chinese) 梅佳玮, 张毅, 张文杰, 等.胆肠吻合术后胆管结石内镜治疗疗效评估 (附17例报告) [J].中国实用外科杂志, 2014, 34 (10) :953-956.
    [6]JIN HB, ZHANG XF, LI SD, et al.Single-balloon enteroscopy assisted ERCP for diagnosis and treatment of patients with biliary obstruction after gastrointestinal reconstruction[J].Chin J Dig Endosc, 2013, 30 (9) :499-502. (in Chinese) 金杭斌, 张筱凤, 李舒丹, 等.单气囊小肠镜辅助下经内镜逆行胰胆管造影术对胃肠改道术后并发胆道梗阻的诊治价值[J].中华消化内镜杂志, 2013, 30 (9) :499-502.
    [7]de KONING M, MOREELS TG.Comparison of double-balloon and single-balloon enteroscope for therapeutic endoscopic retrograde cholangiography after Roux-en-Y small bowel surgery[J].BMC Gastroenterol, 2016, 16 (1) :98.
    [8]MOREELS TG.Endoscopic retrograde cholangiopancreatography in patients with altered anatomy:how to deal with the challenges?[J].World J Gastrointest Endosc, 2014, 6 (8) :345-351.
    [9]YAMAUCHI H, KIDA M, OKUWAKI K, et al.Short-type single balloon enteroscope for endoscopic retrograde cholangiopancreatography with altered gastrointestinal anatomy[J].World J Gastroenterol, 2013, 19 (11) :1728-1735.
    [10]FENG YD, CHEN XX.An excerpt of international consensus recommendations for difficult biliary access in 2016[J].J Clin Hepatol, 2017, 33 (2) :233-237. (in Chinese) 冯亚东, 陈晓星.《2016年国际共识意见:胆管困难入路》摘译[J].临床肝胆病杂志, 2017, 33 (2) :233-237.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (1552) PDF downloads(391) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return