Publication details
Endoskopická retrográdní cholangiografie pomocí jednobalónkového enteroskopu u pacientů s Roux-Y hepatikojejunoanastomózou
| Title in English | Endoscopic retrograde cholangiography with a single-balloon enteroscope in patients with Roux-en-Y hepaticojejunal anastomosis |
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| Authors | |
| Year of publication | 2012 |
| Type | Article in Periodical |
| Magazine / Source | Vnitřní lékařství |
| MU Faculty or unit | |
| Citation | |
| Field | Surgery incl. transplantology |
| Keywords | endoscopic retrograde cholangiography; single balloon enteroscopy; Roux-en-Y hepatico jejunal anastomosis; endoscopic treatment |
| Description | The aim ofthis retrospective study was to evaluate our experience with using a single-balloon enetroscope for diagnostic and therapeutic endoscopic retrograde cholangiography (FRC) in patients with Roux-en-Y hepaticojejunal anastomosis (HJA). Due to the considerably changed anatomic circumstances after the surgery, FRC is, in comparison to the standard endoscopic retrograde cholangiopancraeaticography (FRCP), significantly more difřicult to perform. Patient sample and methodolo The sample was followed upFrom January 2009 to September 2011. The study retrospectively reviewed 14 patients with Roux-en-Y HJA with symptoms oř biliary obstruction. A total of21 ERCs were performed in these 14 Roux-en-Y HJA patients using the single-balloon videoenetroscope Olympus SIF Q 180. Results: Diagnostic FRC cannulation was successful in 11 ofthe 14 patients (79% success rate for the diagnostic FRC). One oř the 11 patients had a normal finding on the FRC. The remaining 10 patients had a pathological finding on FRC that, in one patient (cystic dilatation ořbile duct), was subsequently managed surgically. Fndoscopic treatment was initiated in the remaining 9 patients (HJA steno sis in 4, choledocholithiasis in 2 and concurrent HJA stenosis and choledocholithiasis in 3) immediately afterthe diagnostic FRC; the sur gery was successful in 8 ofthe 9 patients (89% success rate for the therapeutic FRC). The performed endoscopic therapeutic procedures included: balloon dilatation oFHJA stenosis 9 times (6 patients), choledocholithiasis extraction - 5 times (5 patients), biliary plastic stent placement - 5 times (3 patients), removal ořbiliary stents placed by us - 5 times (3 patients). We did not observe any complications in our sample oř 14 patients. Conclusions: FRC using a single-balloon enteroscope in patients with Roux-Y HJA is signi6cantly more diřficult than the standard ERCP dueto different post-surgical anatomy. In our sample ofpatients, we achieved 79% success rate for the diagnostic FRC and 89% success rate Forthe therapeutic FRC. Additional time should be allowed Forthe individual procedures. Furthermore, the presence ofan anaesthesiologist during these operations (deep analgosedation) is essential. This isa technicallyvery demanding technique that, however is effective and safe and importantly extends the options available For the management oř biliary pathologies in these patients. |