Endoscopicretrograde cholangio-pancreatography management of long-term complications after pancreaticoduodenectomy
10.3760/cma.j.issn.0529-5815.2018.11.008
- VernacularTitle: 经内镜逆行胰胆管造影治疗胰十二指肠切除术后远期并发症的结果分析
- Author:
Wenguang WU
1
;
Wenjie ZHANG
;
Jun GU
;
Mingning ZHAO
;
Hao WENG
;
Mingzhe WENG
;
Yi ZHANG
;
Chunying QU
;
Leiming XU
;
Yingbin LIU
;
Xuefeng WANG
Author Information
1. Departments of General Surgery and Laboratory of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine and Institute of Biliary Tract Disease, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
- Publication Type:Journal Article
- Keywords:
Pancreaticoduodenectomy;
Postoperative complications;
Endoscopic retrograde cholangiopancreatography;
Multi-disciplinary collaboration
- From:
Chinese Journal of Surgery
2018;56(11):833-836
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the feasibility and effectiveness of endoscopicretrograde cholangio-pancreatography(ERCP)in the management of long-term complications after pancreaticoduodenectomy.
Methods:From January 2009 to July 2018, the clinical data of 62 patients with biliary or pancreatic long-term complications after pancreatoduodenectomy were reviewed at Department of General Surgery, and the corresponding ERCP were carried out in the multi-disciplinary cooperation.There were 39 males and 24 females.The age was 56.5 years(aging from 13 to 76 years). The time of treatment was 3 months to 20 years after pancreatoduodenectomy.The long-term biliopancreatic complications after pancreatoduodenectomy included 51 cases of biliary calculi, 42 cases of bilioenteric anastomotic stenosis with proximal bile duct dilatation, and 11 cases of pancreaticointestinal anastomosis stenosis with distal pancreatic duct dilatation.All patients received conventional duodenoscopy or single-balloon enteroscopy assisted ERCP under general anesthesia.
Results:A total of 95 ERCP were performed in 62 patients, averaging 1.5 times per case.The long-term complications of cholangiopancreatic after pancreatoduodenectomy(ERCP indications) included 56 times of bile duct stones(58.9%), 45 times of bilioenteric anastomatic stricture(47.4%), 11 times of recurrent pancreatitis(11.6%), 6 cases(6.3%) of bilioenteric anastomatic foreign body, 3 times of intrahepatic bile duct stenosis(3.2%). Among the 95 times, 82 times(86.3%) achieved endoscopic endoscopy, 76 times(80.0%) were diagnosed successfully, and 72 times(75.8%) were successfully treated with ERCP.Small intestinal perforation occurred in 1 patient undergoing duodenoscopy, and then healed by surgical repair.
Conclusion:Multi-disciplinary collaboration of ERCP is safe and effective in the treatment of long-term complications after pancreaticoduodenectomy, but the long-term effect still needs further clinical follow-up.
