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首页> 外文期刊>Endoscopy International Open >Double-balloon enteroscopy for ERCP in patients with Billroth II anatomy: results of a large series of papillary large-balloon dilation for biliary stone removal
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Double-balloon enteroscopy for ERCP in patients with Billroth II anatomy: results of a large series of papillary large-balloon dilation for biliary stone removal

机译：Billroth II解剖学患者的双气囊肠镜用于ERCP：一系列乳头状大气囊扩张术去除胆结石的结果

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Background and study aims: Data on double-balloon enteroscopy (DBE)-assisted endoscopic retrograde cholangiopancreatogrphy (ERCP) in patients with Billroth II gastrectomy and the use of endoscopic papillary large-balloon dilation (EPLBD) for the removal of common bile duct stones in Billroth II anatomy are limited. The aims of the study were to evaluate the success of DBE-assisted ERCP in patients with Billroth II gastrectomy and examine the efficacy of EPLBD (?≥?10?mm) for the removal of common bile duct stones. Patients and methods: A total of 77 patients with Billroth II gastrectomy in whom standard ERCP had failed underwent DBE-assisted ERCP. DBE success was defined as visualizing the papilla and ERCP success as completing the intended intervention. The clinical results of EPLBD for the removal of common bile duct stones were analyzed. Results: DBE was successful in 73 of 77 patients (95?%), and ERCP success was achieved in 67 of these 73 (92?%). Therefore, the rate of successful DBE-assisted ERCP was 87?% (67 of a total of 77 patients). The reasons for ERCP failure (n?=?10) included tumor obstruction (n?=?2), adhesion obstruction (n?=?2), failed cannulation (n?=?3), failed stone removal (n?=?2), and bowel perforation (n?=?1). Overall DBE-assisted ERCP complications occurred in 5 of 77 patients (6.5?%). A total of 48 patients (34 male, mean age 75.5 years) with common bile duct stones underwent EPLBD. Complete stone removal in the first session was accomplished in 36 patients (75?%); mechanical lithotripsy was required in 1 patient. EPLBD-related mild perforation occurred in 2 patients (4?%). No acute pancreatitis occurred. Conclusions: DBE permits therapeutic ERCP in patients who have a difficult Billroth II gastrectomy with a high success rate and acceptable complication rates. EPLBD is effective and safe for the removal of common bile duct stones in patients with Billroth II anatomy.
机译：背景和研究目的：双球肠镜（DBE）辅助内镜下逆行胰胆管造影术（ERCP）在Billroth II胃切除术中的数据，以及使用内镜乳头大气球扩张术（EPLBD）清除胆总管结石Billroth II的解剖结构有限。该研究的目的是评估DBE辅助ERCP在Billroth II胃切除术患者中的成功，并检查EPLBD（≥10mm）清除胆总管结石的功效。患者和方法：共77例标准ERCP失败的Billroth II胃切除术患者接受DBE辅助的ERCP。 DBE成功定义为可视化乳头，而ERCP成功定义为完成预期的干预。分析了EPLBD清除胆总管结石的临床结果。结果：77例患者中有73例DBE成功（95％），这73例中有67例ERCP成功（92 %%）。因此，成功的DBE辅助ERCP的成功率为87％（77名患者中的67名）。 ERCP失败的原因（n = 10）包括肿瘤阻塞（n = 2），粘连阻塞（n = 2），插管失败（n = 3），结石清除失败（n == 10）。 2）和肠穿孔（n 1 ＝ 1）。 DBE辅助的ERCP总体并发症发生于77例患者中的5例（6.5％）。共有48例胆总管结石患者（34例男性，平均年龄75.5岁）接受了EPLBD治疗。在第一阶段中，有36例患者（75％）完成了完全的结石清除; 1例患者需要机械碎石术。有2例患者发生了EPLBD相关的轻度穿孔（4％）。无急性胰腺炎发生。结论：DBE可对患有Billroth II胃切除困难的患者进行治疗性ERCP，并具有较高的成功率和可接受的并发症发生率。 EPLBD可有效清除Billroth II解剖患者的胆总管结石。

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