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外科手术改变解剖结构后经内镜逆行胰胆管造影术的研究进展
李家速1,李宛桐1,刘枫1,2*,李兆申1
0
(1. 海军军医大学(第二军医大学)长海医院消化内科, 上海 200433;
2. 同济大学附属第十人民医院内镜中心, 上海 200072
*通信作者)
摘要:
经内镜逆行胰胆管造影术(ERCP)是目前诊治胆胰疾病的一项重要手段,其中外科手术改变解剖结构(SAA)后ERCP(SAA-ERCP)内镜技术要求更高,操作失败及并发症风险大,对内镜医师而言极具挑战。近年来,随着内镜技术的发展和术者经验的成熟,SAA-ERCP取得诸多进展,操作成功率和并发症发生率已与正常解剖结构患者相当。本文就近年来SAA-ERCP有效性和安全性、内镜及辅助技术等方面的研究进展进行综述,并总结SAA-ERCP临床特点。
关键词:  内镜逆行胰胆管造影术  外科手术改变解剖结构  胃肠吻合术  Roux-en-Y吻合术
DOI:10.16781/j.0258-879x.2019.03.0325
投稿时间:2018-07-17修订日期:2018-09-07
基金项目:国家自然科学基金(81670604).
Endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy: an advance
LI Jia-su1,LI Wan-tong1,LIU Feng1,2*,LI Zhao-shen1
(1. Department of Gastroenterology, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China;
2. Endoscopy Center, the Tenth People's Hospital, Tongji University, Shanghai 200072, China
*Corresponding author)
Abstract:
Endoscopic retrograde cholangiopancreatography (ERCP) is an important technique for the diagnosis and treatment of biliary and pancreatic disorders. ERCP in the patients with surgically altered anatomy (SAA) is more technically demanding with high risks of procedural failure and complications, and it is challenging for the endoscopists. Recently, the development of endoscopic devices and the improvement of operator skills have led to SAA-ERCP progresses. The success rate of ERCP and the incidence of complications are similar to those of the patients with normal anatomy. This paper reviews the recent advances on SAA-ERCP, including the effectiveness and safety, and endoscopy and assisted techniques, and summarizes the clinical features of SAA-ERCP.
Key words:  endoscopic retrograde cholangiopancreatography  surgically altered anatomy  gastroenterostomy  Roux-en-Y anastomosis