Retrospective analysis of endoscopic retrograde cholangiopancreatography in patients with prior Billroth Ⅱ gastrectomy
10.3760/cma.j.issn.1007-5232.2018.11.005
- VernacularTitle:毕Ⅱ式胃切除术后内镜下逆行胰胆管造影术的回顾分析
- Author:
Jiasu LI
1
;
Feng LIU
;
Duowu ZOU
;
Zhendong JIN
;
Dong WANG
;
Xin'gang SHI
;
Jie CHEN
;
Zhaoshen LI
Author Information
1. 第二军医大学附属长海医院消化内科
- Keywords:
Gastrectomy;
Billroth Ⅱ;
Common bile duct stones;
Obstructive jaundice;
Endoscopic retrograde cholangiopancreatography
- From:
Chinese Journal of Digestive Endoscopy
2018;35(11):833-837
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography ( ERCP ) in the treatment of patients with biliary and pancreatic diseases after Billroth Ⅱ gastrectomy. Methods Clinical data of 178 patients with biliary and pancreatic diseases undergoing 237 times of ERCP at the digestive endoscopy center in Changhai Hospital from January 2011 to December 2016 were retrospectively collected. The success rate of procedures and related complications were summed up. Results Among 178 patients undergoing 237 times of ERCP, the successful intubation rate of the endoscope to reach the duodenal papilla was 83. 5％ ( 198/237 ) . The success rate of selective cannulation and completing the expected intervention were 91. 4％ ( 181/198 ) and 98. 9％ ( 179/181 ) , respectively. The total success rate of ERCP was 75. 5％ (179/237), which had an increasing trend with time. The total success rate of ERCP in patients with common bile duct stone was 85. 2％ ( 127/149) , and the stone retrieval rate during the first session was 56. 7％ (72/127). The ERCP-related complication rate was 14. 3％ ( 34/237 ) , with 1. 7％ ( 4/237 ) perforation, 1. 3％ ( 3/237 ) bleeding, 3. 4％ ( 8/237 ) pancreatitis, and 8. 0％ ( 19/237 ) asymptomatic hyperamylasemia. One patient with perforation and 2 patients with severe pancreatitis died of septic shock and multiple organ failure ( 1. 3％, 3/237 ) . Most ERCP-related complications were improved by conservative treatment or second endoscopic intervention ( 91. 2％, 31/34 ) . Conclusion ERCP is effective and safe in the treatment of biliary and pancreatic diseases in patients with prior Billroth Ⅱ gastrectomy. With the development of endoscopic techniques and experience accumulation of endoscopists, the success rate of intubation, selective cannulation and therapeutic intervention can be close to those of patients with normal anatomy, and the incidence of related complications is low.
