外科手术改变解剖结构后经内镜逆行胰胆管造影术的研究进展

Endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy:an advance

经内镜逆行胰胆管造影术(ERCP)是目前诊治胆胰疾病的一项重要手段,其中外科手术改变解剖结构(SAA)后ERCP(SAA-ERCP)内镜技术要求更高,操作失败及并发症风险大,对内镜医师而言极具挑战。近年来,随着内镜技术的发展和术者经验的成熟,SAA-ERCP取得诸多进展,操作成功率和并发症发生率已与正常解剖结构患者相当。本文就近年来SAA-ERCP有效性和安全性、内镜及辅助技术等方面的研究进展进行综述,并总结SAA-ERCP临床特点。

Endoscopic retrograde cholangiopancreatography (ERCP) is an important technique for the diagnosis and treatment of biliary and pancreatic disorders. ERCP in the patients with surgically altered anatomy (SAA) is more technically demanding with high risks of procedural failure and complications, and it is challenging for the endoscopists. Recently, the development of endoscopic devices and the improvement of operator skills have led to SAA-ERCP progresses. The success rate of ERCP and the incidence of complications are similar to those of the patients with normal anatomy. This paper reviews the recent advances on SAA-ERCP, including the effectiveness and safety, and endoscopy and assisted techniques, and summarizes the clinical features of SAA-ERCP.