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

Single-balloon enteroscopy assisted ERCP for diagnosis and treatment of patients with biliary ob- struction after gastrointestinal reconstruction

目的评估单气囊小肠镜辅助下ERCP诊治胃肠改道术后并发胆道梗阻的可行性和安全性。方法回顾性总结7例胃肠改道术后并发胆道梗阻行单气囊小肠镜辅助下ERCP治疗患者的临床资料，统计治疗完成情况、手术时间以及并发症发生情况。结果6例内镜成功到达十二指肠乳头或胆肠吻合口并行ERCP相关治疗，手术成功率达85．7％（6／7），手术时间28～72min，平均42min；另外1例未能成功确认输入袢并找到十二指肠乳头。7例均未发生术中及术后穿孔、急性胰腺炎、出血等严重并发症。结论单气囊小肠镜辅助下ERCP治疗胃肠改道术后并发胆道梗阻是可行的，也是相对安全的。

Objective To evaluate the feasibility and safety of performing endoscopic retrograde cholangiopancreatography （ERCP） assisted by single-balloon enteroscopy （SBE） in patients with biliary obstruction after gastrointestinal reconstruction. Methods Clinical data about 7 cases of single-balloon enteroscopy assisted-ERCP （SBE-ERCP） were summarized including the completion of treatment, operation time, and complications for retrospective study. Results The papilla or anastomotic site was reached and therapeutic ERCP were performed successfully in 6 patients. The overall success rate was 85.7% （ 6/7 ） , and the mean operation time of SBE-ERCP was 42 min （ ranging from 28 to 72 min）. The afferent loop and papilla were failed to be confirmed in 1 patient. No complication such as perforation, panereatitis or bleeding ocurred in all the 7 patients. Conclusion Single-balloon enteroscopy assisted-ERCP （SBE-ERCP） is feasible and relatively safe in postsurgical patients with gastrointestinal reconstruction.