Roux‑en‑Y吻合术后超声内镜引导下经胃肠吻合旁路辅助内镜逆行胰胆管造影术进展（含视频）

Advances in endoscopic ultrasound‑directed gastrointestinal bypass‑assisted endoscopic retrograde cholangiopancreatography after Roux‑en‑Y anastomosis (with video)

摘要:

Roux‑en‑Y吻合术为消化系统外科手术常用术式，主要包括Roux‑en‑Y胃旁路术与Roux‑en‑Y胆肠吻合术。Roux‑en‑Y吻合术后患者的内镜逆行胰胆管造影术（endoscopic retrograde cholangiopancreatography， ERCP）是内镜医师面临的一项挑战。针对这一临床难点，一项新技术——超声内镜引导下经胃肠吻合旁路辅助ERCP，应运而生。该技术在超声引导下创建胃肠吻合旁路，缩短ERCP行镜距离，与现有的各项辅助ERCP技术相比，在插管成功率、操作成功率、手术时间、术后住院时间、费用等方面都具备优势。本文介绍该项辅助ERCP技术的发展过程、适应证、操作步骤、临床疗效、并发症等方面，以期促进该技术在我国的进一步研究与推广。

Abstract:

Roux-en-Y is a common procedure in gastrointestinal surgery, mainly including Roux-en-Y gastric bypass and Roux-en-Y cholangiojejunostomy. Endoscopic retrograde cholangiopancreatography (ERCP) in Roux-en-Y patients is a challenge for endoscopists. In response to this clinical challenge, a new technique, endoscopic ultrasound-directed gastrointestinal bypass-assisted ERCP (EDGE), was developed. This technique shortens the ERCP travel distance by creating an ultrasound-guided gastrointestinal anastomosis bypass, and has advantages over the existing ERCP assisting techniques in terms of intubation success rate, operation success rate, operation time, postoperative hospitalization time, and cost. In this paper, we review the development process, indications, operation procedures, clinical efficacy, and complications in order to promote the research and application of this technique in China.