在Roux-en-Y-anatomy患者中,辅助内镜逆向胆血管学
Simon Nennstiel1, Ron Fried1, Alexander Herner1
1Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich 8091, Switzerland.
World journal of gastrointestinal endoscopy
|August 21, 2025
概括
机动螺旋肠镜辅助ERCP (MSE-ERCP) 是对Roux-en-Y解剖的患者进行胆道干预的可行和安全选择. 这项研究发现高成功率和可控的不良事件,表明尽管设备被撤销,但它的效用仍然很高.
科学领域:
- 胃肠病学
- 最少的入侵性手术
- 内镜检查
背景情况:
- 术后的胃肠上部解剖学,特别是Roux-en-Y重建,对于标准的内逆向胆瘤学 (ERCP) 提出了挑战.
- 电动螺旋肠镜 (MSE) 辅助ERCP (MSE-ERCP) 提供了一个潜在的解决方案,使标准ERCP仪器在复杂的解剖学中能够使用.
研究的目的:
- 评估MSE-ERCP在Roux-en-Y解剖患者中的可行性和安全性.
- 在该患者群体中评估MSE- ERCP的成功率和并发症概况.
主要方法:
- 在2021年9月至2023年5月期间进行的连续MSE-ERCP程序的回顾性分析.
- 包括Roux-en-Y解剖的患者,包括肝移植,胃切除和胃旁路术后的患者.
主要成果:
- 在18名患者中,共进行了26次MSE- ERCP. 达到胆道入口的总体成功率为88%,随后的干预成功率为83%.
- 在Roux-en-Y肢体非常长的患者中,干预时间更长 (133分钟 vs 91分钟).
- 观察到三个不良事件 (每次手术的2. 3%),其中一个与肠镜检查有关,另一个与胆道干预有关.
结论:
- 在Roux-en-Y解剖学患者的胆道干预中,MSE-ERCP显示出可行性和有前途的安全性.
- 尽管MSE最近因安全问题而退出市场,但本研究没有发现与肠镜成分本身相关的重大问题.
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