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Innovations and techniques for balloon-enteroscopeassisted endoscopic retrograde cholangiopancreatography in patients with altered gastrointestinal anatomy

查看全文 作　　者：Hiroshi [1]Yamauchi;Mitsuhiro [1]Kida;Hiroshi [1]Imaizumi;Kosuke [1]Okuwaki;Shiro [1]Miyazawa;Tomohisa [1]Iwai;Wasaburo [1]Koizumi 高影响力作者 机构地区：[1]Department of Gastroenterology,Kitasato University Hospital高影响力机构 出　　处：《World Journal of Gastroenterology》索引2015年第21卷第21期,共10页高影响力期刊 摘　　要：Endoscopic retrograde cholangiopancreatography(ERCP) remains challenging in patients who have undergone surgical reconstruction of the intestine.Recently,many studies have reported that balloonenteroscope-assisted ERCP(BEA-ERCP) is a safe and effective procedure.However,further improvements in outcomes and the development of simplified procedures are required.Percutaneous treatment,Laparoscopy-assisted ERCP,endoscopic ultrasoundguided anterograde intervention,and open surgery are effective treatments.However,treatment should be noninvasive,effective,and safe.We believe that these procedures should be performed only in difficult-to-treat patients because of many potential complications.BEA-ERCP still requires high expertiselevel techniques and is far from a routinely performed procedure.Various techniques have been proposed to facilitate scope insertion(insertion with percutaneous transhepatic biliary drainage(PTBD) rendezvous technique,Short type single-balloon enteroscopes with passive bending section,Intraluminal injection of indigo carmine,CO2 inflation guidance),cannulation(PTBD or percutaneous transgallbladder drainage rendezvous technique,Dilation using screw drill,Rendezvous technique combining DBE with a cholangioscope,endoscopic ultrasound-guided rendezvous technique),and treatment(overtube-assisted technique,Short type balloon enteroscopes) during BEA-ERCP.The use of these techniques may allow treatment to be performed by BEA-ERCP in many patients.A standard procedure for ERCP yet to be established for patients with a reconstructed intestine.At present,BEA-ERCP is considered the safest and most effective procedure and is therefore likely to be recommended as firstline treatment.In this article,we discuss the current status of BEA-ERCP in patients with surgically altered gastrointestinal anatomy. 关 键 词：Balloon ENTEROSCOPY Endoscopic retrogradecholangiopancreatography ALTERED GASTROINTESTINAL ANATOMY Balloon-enteroscope-assisted endoscopicretrograde cholangiopancreatography
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