摘要
AIM: To evaluate double balloon enteroscopy (DBE) in post-surgical patients to perform endoscopic retrograde cholangiopancreatography (ERCP) and interventions. METHODS: In 37 post-surgical patients, a stepwise approach was performed to reach normal papilla or enteral anastomoses of the biliary tract/pancreas. When conventional endoscopy failed, DBE-based ERCP was performed and standard parameters for DBE, ERCP and interventions were recorded. RESULTS: Push-enteroscopy (overall, 16 procedures) reached enteral anastomoses only in six out of 37 post-surgical patients (16.2%). DBE achieved a high rate of luminal access to the biliary tract in 23 of the remaining 31 patients (74.1%) and to the pancreatic duct (three patients). Among all DBE-based ERCPs (86 procedures), 21/23 patients (91.3%) were successfully treated. Interventions included ostium incision or papillotomy in 6/23 (26%) and 7/23 patients (30.4%), respectively. Biliary endoprosthesis insertion and regular exchange was achieved in 17/23 (73.9%) and 7/23 patients (30.4%), respectively. Furthermore, bile duct stone extraction as well as ostium and papillary dilation were performed in 5/23 (21.7%) and 3/23 patients (13.0%), respectively. Complications during DBE-based procedures were bleeding (1.1%), perforation (2.3%) and pancreatitis (2.3%), and minor complications occurred in up to 19.1%. CONCLUSION: The appropriate use of DBE yields a high rate of luminal access to papilla or enteral anastomoses in more than two-thirds of post-surgical patients, allowing important successful endoscopic therapeutic interventions.
AIM： To evaluate double balloon enteroscopy （DBE） in post-surgical patients to perform endoscopic retrograde cholangiopancreatography （ERCP） and interventions. METHODS： In 37 post-surgical patients, a stepwise approach was performed to reach normal papilla or enteral anastomoses of the biliary tract/pancreas. When conventional endoscopy failed, DBE-based ERCP was performed and standard parameters for DBE, ERCP and interventions were recorded. RESULTS： Push-enteroscopy （overall, 16 procedures） reached enteral anastomoses only in six out of 37 post-surgical patients （16.2%）. DBE achieved a high rate of luminal access to the biliary tract in 23 of the remaining 31 patients （74.1%） and to the pancreatic duct （three patients）. Among all DBE-based ERCPs （86 procedures）, 21/23 patients （91.3%） were successfully treated. Interventions included ostium incision or papillotomy in 6/23 （26%） and 7/23 patients （30.4%）, respectively. Biliary endoprosthesis insertion and regular exchange was achieved in 17/23 （73.9%） and 7/23 patients （30.4%）, respectively. Furthermore, bile duct stone extraction as well as ostium and papillary dilation were performed in 5/23 （21.7%） and 3/23 patients （13.0%）, respectively. Complications during DBE-based procedures were bleeding （1.1%）, perforation （2.3%） and pancreatitis （2.3%）, and minor complications occurred in up to 19.1%. CONCLUSION： The appropriate use of DBE yields a high rate of luminal access to papilla or enteral anastomoses in more than two-thirds of post-surgical patients, allowing important successful endoscopic therapeutic interventions.
关键词
双气囊
小肠
手术
患者
胆管
造影
内镜
胃镜检查
Double balloon enteroscopy
Endoscopic retrograde cholangiopancreatography
Choledochojejunostomy
Hepaticojejunostomy
Pancreaticojejunostomy
Percutaneous cholangiodrainage
