Endoscopic retrograde cholangiopancreatography after Billroth-Ⅱ gastrectomy and its safety
-
摘要: 目的探讨胃Billroth-Ⅱ式术后经内镜逆行胰胆管造影(ERCP)技术及其安全性。方法对2012年6月-2015年6月兰州军区乌鲁木齐总医院收治的胃Billroth-Ⅱ式术后43例患者行ERCP。结果 43例行ERCP的患者中插管成功39例(90.7%),插管失败2例(4.7%),并发消化道穿孔2例(4.7%)。39例患者中经ERCP诊断为胆总管结石31例(79.5%),其中3例行乳头括约肌切开术、28例行内镜下乳头球囊扩张术取石;诊断为胆管末端良性狭窄6例(15.4%),其中4例行单纯乳头球囊扩张术、2例行胆道塑料支架置入术;诊断为壶腹部肿瘤、胃癌肝门部转移各1例(2.6%),分别置入胆道金属支架、塑料支架。术后急性胰腺炎1例(2.6%)。结论对胃Billroth-Ⅱ式术后患者进行ERCP检查及治疗是安全、有效的,可在临床推广应用。
-
关键词:
- 胰胆管造影术,内窥镜逆行 /
- 胃肠吻合术
Abstract: Objective To investigate the safety of endoscopic retrograde cholangiopancreatography(ERCP) after Billroth- Ⅱ gastrectomy.Methods A total of 43 patients who were admitted to our hospital and underwent Billroth-Ⅱ gastrectomy from June 2012 to June 2015 were enrolled and underwent ERCP.Results Of all 43 patients undergoing ERCP,39(90.7%) received successful intubation,2(4.7%) received failed intubation,and 2(4.7%) experienced the complication of digestive tract perforation.Among the 39 patients who underwent ERCP,31(79.5%) were diagnosed with common bile duct stones(3 underwent sphincterotomy and 28 underwent endoscopic papillary balloon dilation to remove stones),6(15.4%) were diagnosed with benign stenosis at the end of bile duct(4 underwent papillary balloon dilation alone and 2 underwent biliary plastic stent implantation),and 1 patient each(2.6%) was diagnosed with ampullary tumor and hepatic portal metastasis of gastric cancer and received implantation of metal and plastic stents,respectively.One patient(2.6%) experienced acute pancreatitis after surgery.Conclusion ERCP is safe and effective in patients after Billroth-Ⅱgastrectomy and holds promise for clinical application.-
Key words:
- cholangiopancreatography /
- endoscopic retrograde
-
[1]FANG CY,HE LP,ZHENG XL,et al.Diagnosis and treatment of pancreaticobiliary diseases after Billroth II subtotal gastrectomy[J].Chin J Digest Surg,2011,10(1):70.(in Chinese)方超英,何利平,郑晓玲,等.Billro IhⅡ式胃大部切除术后胆胰疾病的诊断和治疗[J].中华消化外科杂志,2011,10(1):70. [2]CHEUNG J,TSOI KK,OUAN WL,et al.Guidewire versus conventiona I contrast cannu Iation of the common bi Ie duct for the prevention of post-ERCP pancreatitis:a systematic review and metaana Iysis[J].Gastrointest Endosc,2009,70(6):1211-1219. [3]LIN CH,TANG JH,CHENG CL,et al.Doub Ie ba IIoon endoscopy increases the ERCP success rate in patients with a history of Bi IIroth-Ⅱgastrectomy[J].Wor Id J Gastroentero I,2010,16(36):4594-4598. [4] ZHANG ST,JI M,YU ZL.Standadization of endoscopic retrograde cholangiopancreatography[J].Chin J Dig Endosc,2009,26(7):337-338.(in Chinese)张澍田,冀明,于中麟.ERCP技术规范化要领[J].中华消化内镜杂志,2009,26(7):337-338. [5]SWARNKAR K,STAMATK JD,YOUNG WT.Diagnostic and therapeutic endospic retrograde cholangiopancreatcography after Billroth-Ⅱgastrectomy-safe provision in a district general hospital[J].Ann R Coll Surg Engl,2005,87(5):274-276. [6]ZHANG QY.Qian Li.Abdominal surgery[M].Beijing:People's Medical Publishing House,2006:175.(in Chinese)张启瑜.钱礼腹部外科学[M].北京:人民卫生出版社,2006:175. [7]YIN P,MA EW,BAO WM,et al.Lateral endoscopic treatment of bile duct diseases after Billroth II subtotal gastrectomy and anastomosis[J].Chin J Hepatobiliary Surg,2005,11(9):609-611.(in Chinese)殷评,马恩伟,包文敏,等.胃大部切除毕Ⅱ式吻合术后胆管疾病的侧视镜下治疗[J].中华肝胆外科杂志,2005,11(9):609-611. [8]BERGMAN JJ,van BERKEL AM,BRUNO MJ,et al.A randomized trial of endoscopic balloon dilation and endoscopic sphincterotomy for removal of bile duet stones in patients with a prior BillrothⅡgastrectomy[J].Gastrointest Endosc,2001,53(1):19-26. [9]NATHANS LK,O'ROURKE NA,MARTIN IJ,et al.Postoperative ERCP versus laparoscopic choledochotomy for clearance of selected bile duct calculi:a randomized trial[J].Ann surg,2005,242(2):188-192.
本文二维码
计量
- 文章访问数: 2048
- HTML全文浏览量: 26
- PDF下载量: 447
- 被引次数: 0