短单气囊小肠镜在Roux-en-Y术后患者经内镜逆行胰胆管造影中的应用

Clinical application of short-type single balloon enteroscope to endoscopic retrograde cholangiopancreatography in patients with Roux-en-Y anastomosis

目的评估短单气囊小肠镜(single balloon enteroscope,SBE)辅助下经内镜逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)在Roux-en-Y术后患者中的应用价值。方法收集鼓楼医院消化内镜中心2019年5月—2019年9月行短SBE辅助ERCP诊治的10例Roux-en-Y术后患者(14例次ERCP,短SBE组)和2016年3月—2019年4月行常规SBE辅助ERCP诊治的55例Roux-en-Y术后患者(87例次ERCP,常规SBE组)的资料。对比短SBE组和常规SBE组到达盲袢的成功率和平均时间、诊断成功率、治疗成功率、手术时间和并发症发生率。结果短SBE组和常规SBE组到达盲袢的平均时间分别为17.1 min和23.4 min,差异有统计学意义(P=0.04)。两组到达盲袢成功率分别为和100.0%(14/14)和95.4%(83/87)。短SBE组和常规SBE手术平均时间分别为62.6 min和64.3 min,两组诊断和治疗成功率均为100.0%,并发症发生率分别为21.4%(3/14)和16.1%(14/83),但两组差异均无统计学意义(P均>0.05)。结论常规SBE和短SBE辅助下ERCP均可安全有效诊疗Roux-en-Y术后患者,但短SBE由于设计独特和好的操控性更易更快到达盲袢。

Objective To evaluate the short-type single balloon enteroscope(SBE)to endoscopic retrograde cholangiopancreatography(ERCP)in patients with Roux-en-Y anastomosis.Methods Data of 10 patients with Roux-en-Y anastomosis who received short-type SBE assisting ERCP(14 times of ERCP,the short-type SBE group)from May 2019 to September 2019 and 55 patients who received conventional SBE assisting ERCP(87 times of ERCP,the conventional SBE group)from March 2016 to April 2019 were collected in Nanjing Drum Tower Hospital.Success rates and mean time of reaching the blind loop,diagnosis and treatment success rates,procedure time and complication incidence in the two groups were compared.Results The mean time to reach the blind loop was significantly shorter in short-type SBE group than that in the conventional SBE group(17.1 min VS 23.4 min,P=0.04).There were no significant differences in success rates of reaching the blind loop[100.0%(14/14)VS 95.4%(83/87)],the success rates of diagnosis and treatment[both 100.0%(14/14)VS 100.0%(83/83)],the mean procedure time(62.6 min VS 64.3 min)or complication incidence[21.4%(3/14)VS 16.1%(14/83)]between the two groups(all P>0.05).Conclusion ERCP assisted by either type of SBE is safe and effective in patients with Roux-en-Y anastomosis.However,short-type SBE is faster to reach the blind loop because of its unique design and easier manipulation.