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Conventional endoscopic retrograde cholangiopancreaticography vs the Olympus V-scope system

World Journal of Gastroenterology 2013年第12期19卷 1936-1942页

作者： Martin Raithel Andreas Ngel Jürgen Maiss Dane Wildner Alexander Fritzkarl Hagel Sandra Braun Hiwot Diebel Eckhart Georg Hahn Department of Medicine 1 GastroenterologyEndoscopy University Erlangen-Nuremberg

AIM: To compare the new Olympus V-scope (VS) to conventional endoscopic retrograde cholangiopancreati-cography (ERCP). METHODS: Forty-nine patients with previous endoscopic papillotomy who were admitted for interventional ERCP for one of several reasons were included in this single-centre, prospective randomized study. Consecutive patients were randomized to either the VS group or to the conventional ERCP group. ERCP-nave patients who had not undergone papillotomy were excluded. The main study parameters were interventional examination time, X-ray time and dose, and premedication dose (all given below as the median, range) and were investigated in addition to each patient's clinical outcome and complications. Subjective scores to assess each procedure were also provided by the physicians and endoscopy assistants who carried out the procedures. A statistical analysis was carried out using the Wilcoxon rank-sum ***: Twenty-five patients with 50 interventions were examined with the VS ERCP technique, and 24 patients with 47 interventions were examined using the conventional ERCP technique. There were no significant differences between the two groups regarding the age, sex, indications, degree of ERCP difficulty, or interventions performed. The main study parameters in the VS group showed a nonsignificant trend towards a shorter interventional examination time (29 min, 5-50 min vs 31 min, 7-90 min, P = 0.28), shorter X-ray time (5.8 min, 0.6-14.1 min vs 6.1 min, 1.6-18.8 min, P = 0.48), and lower X-ray dose (1351 cGy/m2 , 159-5039 cGy/m2 vs 1296 cGy/m2 , 202.2-6421 cGy/m 2 , P = 0.34). A nonsignificant trend towards fewer adverse events occurred in the VS group as compared with the conventional ERCP group (cholangitis: 12% vs 16%, P = 0.12; pain: 4% vs 12.5%, P = 0.33; post-ERCP pancreatitis: 4% vs 12.5%, P = 0.14). In addition, there were no statistically significant differences in assessment by the physicians and endoscopy assistants using subjective questio

关键词： Endoscopic retrograde cholangiopancre-aticography Short guidewire endoscopic retrograde cholangiopancreaticography system X-ray protection V-scope Bile duct stenosis

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Endoscopic ultrasound-guided drainage of the biliary system:Techniques,indications and future perspectives

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World Journal of Gastrointestinal Endoscopy 2019年第2期11卷 103-114页

作者： Pieter Hindryckx Helena Degroote David J Tate Pierre H Deprez Department of Gastroenterology University Hospital of Ghent Hepato-Gastroenterology Department Cliniques universitaires Saint-Luc

Over the last decade, endoscopic ultrasound-guided biliary drainage(EUS-BD)has evolved into a widely accepted alternative to the percutaneous approach in cases of biliary obstruction with failed endoscopic retrograde cholangiopancreaticography(ERCP). The available evidence suggests that, in experienced hands, EUS-BD might even replace ERCP as the first-line procedure in specific situations such as malignant distal bile duct obstruction. The aim of this review is to summarize the available data on EUS-BD and propose an evidence-based algorithm clarifies the role of the different EUS-BD techniques in the management of benign and malignant biliary obstructive disease.

关键词： Endoscopic ultrasound Endoscopic retrograde cholangiopancreaticography Biliary drainage Rendez-vous Hepaticogastrostomy Choledochoduodenostomy

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