使用气球辅助内镜的ERCP与Roux-en-Y胃切除术中常见胆道结石的EUS引导治疗相比
Tatsuya Sato1, Yousuke Nakai2, Hirofumi Kogure1
1Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Gastrointestinal endoscopy
|September 14, 2023
概括
气球辅助ERCP (BE-ERCP) 和EUS指导的前期治疗 (EUS-AG) 在Roux-en-Y胃切除术患者的普通胆道结石去除方面显示出可比的有效性. 然而,BE-ERCP在技术成功后实现了更高的完整石头去除率.
科学领域:
- 胃肠病学 胃肠病学
- 内镜手术是一种内镜手术.
- 胆道干预措施 胆道干预
背景情况:
- 经过Roux-en-Y (R-Y) 胃切除术的患者对于普通胆道 (CBD) 石头的去除具有独特的挑战.
- 内镜逆行胆血管细胞造影 (ERCP) 和EUS引导的前级治疗 (EUS-AG) 是潜在的治疗选择.
研究的目的:
- 为了比较气球辅助ERCP (BE-ERCP) 与R-Y胃切除术患者的CBD石头去除的EUS引导前级治疗 (EUS-AG) 的有效性和安全性.
主要方法:
- 在16个中心对连续接受BE-ERCP或EUS-AG治疗CBD石头的患者进行了回顾性分析.
- 技术成功的比较,完整的石头去除,不良事件,治疗次数和治疗时间.
主要成果:
- 技术成功率相似 (83.7%的BE-ERCP与EUS-AG相比为83.1%).
- 在BE-ERCP中,完整的石头去除率更高 (78.1%与67.8%相比),特别是在胆道接入后 (93.3%与81.6%相比).
- BE-ERCP需要更少的疗程,但治疗时间更长;早期不良事件发生率相似.
结论:
- 在R-Y胃切除术后的患者中,BE-ERCP和EUS-AG证明了CBD石头去除的可比性安全性和有效性.
- 在这种患者群体的技术成功之后,BE-ERCP提供了更高的完整石头去除率.
相关概念视频
01:26Endoscopic Procedures V: ERCP
332
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Patient...
332
01:29Endoscopic Procedures I: Esophagogastroduodenoscopy
157
An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
During an EGD, the endoscope can be used to:
157
01:28Endoscopic Procedures III: Video Capsule Endoscopy
186
Capsule endoscopy, or wireless or video capsule endoscopy, is a diagnostic procedure for examining the entire gastrointestinal tract. Patients swallow a capsule about the size of a vitamin tablet. The capsule is equipped with a transmitter, a battery, an LED light source, and a color video camera to capture images throughout the gastrointestinal tract. This procedure is particularly useful for diagnosing conditions such as Crohn's disease, ulcerative colitis, tumors, polyps, ulcers,...
186
01:25Ultrasound II: Endoscopic Ultrasound and FibroScan
136
Endoscopic Ultrasound (EUS) and FibroScan are valuable diagnostic tools in gastroenterology and hepatology, each with specific applications and techniques.
Endoscopic Ultrasound (EUS):
Endoscopic Ultrasound (EUS):
136