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Evaluation of the margins of differentiated early gastriccancer by using conventional endoscopy

World Journal of Gastrointestinal Endoscopy 2015年第6期7卷 665-669页

Progress in double-balloon endoscopy （DBE） hasallowed for the diagnosis and treatment of disease inthe postoperative bowel. For example, a short DBE,which has a 2.8 mm working channel and 152 cmworking length, is useful for endoscopic retrogradecholangiopancreatography in bowel disease ***, afferent loop and Roux-limb obstruction,though rare, is caused by postoperative recurrence ofbiliary tract cancer with intractable complications. Mostof the clinical findings involving these complicationsare relatively nonspecific and include abdominal pain,nausea, vomiting, fever, and obstructive *** by surgery, percutaneous transhepaticbiliary drainage, percutaneous enteral stent insertion,and endoscopic therapy have been reported. Thegeneral conditions of patients with these complicationsare poor due to cancer progression; therefore, a lessinvasive treatment is better. We report on the usefulnessof metallic stent insertion using an overtube for afferentloop and Roux-limb obstruction caused by postoperativerecurrence of biliary tract cancer under short DBE in twopatients with complexly reconstructed intestines.

关键词： Afferent loop obstruction Double balloonendoscopy Overtube Metallic stent Biliary tract cancer

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Review of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography using several endoscopic methods in patients with surgically altered gastrointestinal anatomy

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World Journal of Gastrointestinal Endoscopy 2015年第6期7卷 617-627页

作者： Masaaki Shimatani Makoto Takaoka Mitsuo Tokuhara Hideaki Miyoshi Tsukasa Ikeura Kazuichi Okazaki Third Department of Internal Medicine Kansai Medical University

The endoscopic approach for biliary diseases in patients with surgically altered gastrointestinal anatomy(SAGA) had been generally deemed impractical. However, it was radically made feasible by the introduction of double balloon endoscopy(DBE) that was originally developed for diagnosis and treatments for small-bowel diseases. Followed by the subsequent development of singleballoon endoscopy(SBE) and spiral endoscopy(SE), interventions using several endoscopes for biliary disease in patients with SAGA widely gained an acceptance as a new modality. Many studies have been made on this new technique. Yet, some problems are to be solved. For instance, the mutual unavailability among devices due to different working lengths and channels, and unestablished standardization of procedural techniques can be raised. Additionally, in an attempt to standardize endoscopic procedures, it is important to evaluate biliary cannulating methods by case with existence of papilla or not. A full comprehension of the features of respective scope types is also required. However there are not many papers written as a review. In our manuscript, we would like to evaluate and make a review of the present status of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography applying DBE, SBE and SE for biliary diseases in patients with SAGA for establishment of these modalities as a new technology and further improvement of the scopes and devices.

关键词： Double balloon endoscopy Single balloonendoscopy Spiral endoscopy Endoscopic retrogradecholangiopancreatography Roux-en-Y reconstruction

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