ERCP内镜微创治疗消化道重建术后胆胰管梗阻性病变研究进展  

Progress in minimally invasive treatment of biliary pancreatic duct obstruction after digestive tract reconstruction by endoscopic retrograde cholangiopancreatography

作　　者：王如意 范震 Ru-Yi Wang;Zhen Fan(The Fourth School of Clinical Medicine,Zhejiang Chinese Medical University,Hangzhou First People’s Hospital,Hangzhou 310053,Zhejiang Province,China;Department of Gastroenterology,Hangzhou First People’s Hospital Affiliated to Westlake University,Hangzhou 310006,Zhejiang Province,China)

机构地区：[1]浙江中医药大学第四临床医学院(杭州市第一人民医院),浙江省杭州市310053 [2]西湖大学附属杭州市第一人民医院消化内科,浙江省杭州市310006

出　　处：《世界华人消化杂志》2024年第7期490-500,共11页World Chinese Journal of Digestology

基　　金：杭州市医药卫生科技项目,No.ZD20240015.

摘　　要：随着经内镜逆行性胰胆管造影术(endoscopic retro-grade cholangiopancreatography,ERCP)的不断完善和进步,使得ERCP在治疗胆胰管梗阻性病变的应用越来越广泛.在正常胃肠道解剖结构患者中,ERCP的成功率超过95%.然而,消化道重建术后ERCP的内镜入路冗长且复杂,输入攀和吻合口识别困难,肠管粘连及成角等问题,使得ERCP内镜微创治疗胆胰管梗阻病变得极具挑战性,给内镜医生带来不少困难.不同的消化道重建术式,ERCP操作技术的侧重点各不相同.本文结合文献及临床经验,针对不同的消化道重建术后ERCP操作技巧、内镜选择策略及新型辅助技术等方面作一系统阐述.With the continuous improvement and progress of endo-scopic retrograde cholangiopancreatography(ERCP),its application in the treatment of biliary and pancreatic duct obstruction is more and more extensive.The success rate of ERCP in patients with normal gastrointestinal anatomy is more than 95%.However,the endoscopic approach of ERCP after digestive tract reconstruction is lengthy and complicated,with difficulties in the identification of the afferent loop and anastomosis,intestinal duct adhesion,and angulation,which make the minimally invasive treatment of biliary and pancreatic duct obstruction by ERCP extremely challenging and bring many difficulties to endoscopists.The key points of ERCP operation are different for different types of digestive tract reconstruction.Based on the literature and clinical experience,this paper systematically expounds the different ERCP operation techniques,endoscope selection strategies,and new auxiliary technologies after digestive tract reconstruction.

关 键 词：经内镜逆行性胰胆管造影术 消化道重建 内窥镜技术 胆胰管梗阻 微创治疗 

分 类 号：R576[医药卫生—消化系统]