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首页> 外文期刊>Surgical Endoscopy >Outcomes of endoscopic treatment for malignant biliary obstruction in patients with surgically altered anatomy: analysis of risk factors for clinical failure
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Outcomes of endoscopic treatment for malignant biliary obstruction in patients with surgically altered anatomy: analysis of risk factors for clinical failure

机译：手术改变解剖学患者对恶性胆道阻塞的内镜治疗结果：临床失败危险因素分析

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Background To evaluate the outcomes of endoscopic retrograde cholangiopancreatography (ERCP) for malignant biliary obstruction (MBO) using short-type double-balloon enteroscope (sDBE) in patients with surgically altered anatomy. Methods A total of 45 patients with surgically altered anatomy underwent ERCP using sDBE for the treatment of MBO between April 2011 and March 2019. We retrospectively evaluated the clinical and technical success (insertion and biliary intervention success), adverse events, and risk factors for clinical failure. Results The scope was successfully inserted in the target site in 82.2% of patients (37/45), and among them, biliary intervention success was achieved in 86.4% (32/37). The overall technical success rate was 71.1% (32/45) and clinical success rate was 68.9% (31/45), with an adverse event rate of 11.1%. In multivariate analysis, the presence of peritoneal dissemination (odds ratio, 7.3; 95% confidence interval, 1.5-43.5, p = 0.02) was as an independent risk factor for clinical failure. The clinical success rate was 38.5% in patients with peritoneal dissemination and 81.3% in those without peritoneal dissemination. Conclusion Endoscopic treatment using sDBE in patients without peritoneal dissemination provided favorable outcomes, and it can be an initial treatment for MBO in patients with surgically altered anatomy.
机译：背景：评估内镜逆行胰胆管造影（ERCP）在外科解剖改变患者中应用短型双气囊小肠镜（sDBE）治疗恶性胆道梗阻（MBO）的效果。方法2011年4月至2019年3月，共有45例解剖结构发生手术改变的患者，采用sDBE行ERCP治疗MBO。我们回顾性评估了临床和技术成功（插入和胆道介入成功）、不良事件和临床失败的风险因素。结果82.2%（37/45）的患者成功地将内镜插入靶点，其中86.4%（32/37）的患者成功地进行了胆道介入治疗。总体技术成功率为71.1%（32/45），临床成功率为68.9%（31/45），不良事件发生率为11.1%。在多变量分析中，腹膜播散（优势比7.3；95%可信区间1.5-43.5，p=0.02）是临床失败的独立危险因素。有腹膜播散的患者临床成功率为38.5%，无腹膜播散的患者临床成功率为81.3%。结论在无腹膜播散的患者中使用sDBE进行内镜治疗可获得良好的疗效，并可作为外科解剖改变患者MBO的初步治疗。

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