Roux-en-Y胃旁路术后胆囊结石内镜下不同取石方式概述

Overview of different endoscopic lithotripsy methods for cholecystolithiasis after Roux-en-Y gastric bypass

Roux-en-Y胃旁路术(RYGB)后患者发生胆总管结石较为常见。由于患者术后解剖结构的改变,传统的以十二指肠镜为主的内镜下取石术对于患者和医师均是一项巨大的挑战。近年来,随着科技的进步,逐渐发展形成了多种内镜下取石技术,同时为了提高RYGB患者取石成功率,降低并发症发生率,研究者开发了另外途径的内镜逆行胰胆管造影术(ERCP)技术,包括腹腔镜辅助ERCP、经皮辅助假体内镜治疗、超声内镜引导下经胃ERCP和会合导丝辅助ERCP等。鉴于不同内镜下取石术均有不同的优缺点,本文对RYGB后患者不同内镜下取石方式进行了文献回顾,以期为临床医师提供更多的参考帮助。

Choledocholithiasis is common in patients after Roux-en-Y gastric bypass(RYGB).Due to the change of postoperative anatomical structure,the conventional duodenoscopic lithotripsy is a great challenge to both patients and clinicians.In recent years,with the progress of science and technology,multiple endoscopic lithotripsy methods have been gradually developed.At the same time,in order to improve the success rate of lithotripsy in patients with RYGB and reduce the incidence of complications,researchers have developed alternative endoscopic retrograde cholangiopancreatography(ERCP)techniques,such as laparoscopic assisted ERCP,percutaneous assisted prosthetic endoscopic therapy,endoscopic ultrasonography guided gastric ERCP,and rendezvous guidewire-assisted ERCP.In view of the advantages and disadvantages of different endoscopic lithotripsy,this paper reviews the literature of different endoscopic lithotripsy methods in patients after RYGB,in order to provide more references and help for clinicians.