clinendoКлиническая эндоскопияFilin’s Clinical endoscopy2415-7813"Global Media technology" Ltdclinendo-316Research ArticleЛЕКЦИЯЭндоскопические транспапиллярные вмешательства у больных после резекции желудкаКороткевичА. Г.alkorot@mail.ruЧуркинМ. В.mvchl4@bk.ruСнигиревЮ. В.basia@zaoproxy.ruНовокузнецкий государственный институт усовершенствования врачей (НГИУВ)Russian FederationМГКБ №3Russian FederationМГКБ №5Russian Federation20080912202522032Copyright © Короткевич А.Г., Чуркин М.В., Снигирев Ю.В., 20252025Короткевич А.Г., Чуркин М.В., Снигирев Ю.В.Короткевич А.Г., Чуркин М.В., Снигирев Ю.В.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://clinendo.elpub.ru/jour/article/view/316

Анализируются возможности и эффективность диагностических и лечебных вмешательств на папилле после резецирующих операций на желудке. Проанализирована литература с 1986 по 2007 гг. и собственные результаты дуоденоскопии, ЭРПХГ и ЭПСТ на резецированном желудке в модификации Бильрот1 и Бильрот-2 у 37 больных трех ведущих лечебных учреждений Кемеровской области. Изучены возможности эндоскопов с торцевым и боковым расположением окна, частота успешной визуализации, способы интубации кишки, эффективность ЭРПХГ и ретроградных лечебных вмешательств. Показана высокая частота успешных интубаций кишки и ретроградных вмешательств - 68%-87%, безопасность эндоскопии.

ReferencesВоротынцев А.С., Юстищев В.К., Кириллин А.В., Меграбян РА. Выбор дифференцированной тактики лечения больных острым холециститом, осложненным гнойным холангитом. РМЖ 15 декабря 2005 г, том 13, № 25: 1642-1647Воротынцев А.С., Юстищев В.К., Кириллин А.В., Меграбян РА. Выбор дифференцированной тактики лечения больных острым холециститом, осложненным гнойным холангитом. РМЖ 15 декабря 2005 г, том 13, № 25: 1642-1647Луцевич Э.В., Астапенко В.Г., Белов И.Н. Руководство по гастроинтестинальной эндоскопии. Мн.: Выш.шк., 1990 - 303 с.Луцевич Э.В., Астапенко В.Г., Белов И.Н. Руководство по гастроинтестинальной эндоскопии. Мн.: Выш.шк., 1990 - 303 с.Нажипов Р.Д. Оптимизация новых технологий миниинвазив-ной хирургии в лечении рецидивного и резидуального холедохо-литиаза. Автореферат..к.м.н. - Уфа 2007, 25 с.Нажипов Р.Д. Оптимизация новых технологий миниинвазив-ной хирургии в лечении рецидивного и резидуального холедохо-литиаза. Автореферат..к.м.н. - Уфа 2007, 25 с.Элин А.Ф., Медведев А.В. Миниинвазивные хирургические вмешательства у больных с острым гнойным холангитом и обту-рационной желтухой. Третий конгресс ассоциации хирургов имени Н.И. Пирогова 2007: материалы конгресса http://expo.medi.ru/ surg0VSurg1346.htmЭлин А.Ф., Медведев А.В. Миниинвазивные хирургические вмешательства у больных с острым гнойным холангитом и обту-рационной желтухой. Третий конгресс ассоциации хирургов имени Н.И. Пирогова 2007: материалы конгресса http://expo.medi.ru/ surg0VSurg1346.htmЮрченко В.В. Эндоскопическая ретроградная коррекция желчеоттока при патологии билио-панкреато-дуоденальной зоны: автореф.. к.м.н. Иркутск - 2007, 42 с.Юрченко В.В. Эндоскопическая ретроградная коррекция желчеоттока при патологии билио-панкреато-дуоденальной зоны: автореф.. к.м.н. Иркутск - 2007, 42 с.Aabakken L, Bretthauer, Lundin K.E.A. ERCP in patients with a Roux-Y anastomosis using the double balloon enteroscope. Endoscopy 2006:38 (Suppl. II) A25Aabakken L, Bretthauer, Lundin K.E.A. ERCP in patients with a Roux-Y anastomosis using the double balloon enteroscope. Endoscopy 2006:38 (Suppl. II) A25Aabakken L, Holthe B, Sandstad O, Rosseland A, Osnes M. Endoscopic pancreaticobiliary procedures in patients with a Billroth II resection: a 10-year follow-up study. Ital J Gastroenterol Hepatol. 1998 Jun;30(3):301-5.Aabakken L, Holthe B, Sandstad O, Rosseland A, Osnes M. Endoscopic pancreaticobiliary procedures in patients with a Billroth II resection: a 10-year follow-up study. Ital J Gastroenterol Hepatol. 1998 Jun;30(3):301-5.Bagci S, Tuzun A, Ates Y. et al, Efficacy and safety of endoscopic retrograde cholangiopancreatography in patients with Billroth II anastomosis. Hepatogastroenterology. 2005 Mar-Apr;52(62):356-9.Bagci S, Tuzun A, Ates Y. et al, Efficacy and safety of endoscopic retrograde cholangiopancreatography in patients with Billroth II anastomosis. Hepatogastroenterology. 2005 Mar-Apr;52(62):356-9.Baron TH. Double-balloon enteroscopy to facilitate retrograde PEG placement as access for therapeutic ERCP in patients with long-limb gastric bypass. Gastrointest Endosc 2006;64:973-4.Baron TH. Double-balloon enteroscopy to facilitate retrograde PEG placement as access for therapeutic ERCP in patients with long-limb gastric bypass. Gastrointest Endosc 2006;64:973-4.Bergman JJ, van Berkel AM, Bruno MJ etal. A randomized trial of endoscopic balloon dilation and endoscopic sphincterotomy for removal of bile duct stones in patients with a prior Billroth II gastrectomy. Gastrointest Endosc. 2001 Jan;53(1): 19-26Bergman JJ, van Berkel AM, Bruno MJ etal. A randomized trial of endoscopic balloon dilation and endoscopic sphincterotomy for removal of bile duct stones in patients with a prior Billroth II gastrectomy. Gastrointest Endosc. 2001 Jan;53(1): 19-26Ci3ek B, Parlak E, Dieibeyaz S et ai. Endoscopic retrograde cholangiopancreatography in patients with Billroth II gastroenterostomy. J Gastroenterol Hepatol. 2007 Aug;22(8): 1210-3.Ci3ek B, Parlak E, Dieibeyaz S et ai. Endoscopic retrograde cholangiopancreatography in patients with Billroth II gastroenterostomy. J Gastroenterol Hepatol. 2007 Aug;22(8): 1210-3.Chong VH, Yim HB, Lim CC. Endoscopic retrograde cholangiopancreatography in the elderly: outcomes, safety and complications. Singapore Med J. 2005 Nov:46(11/621-6Chong VH, Yim HB, Lim CC. Endoscopic retrograde cholangiopancreatography in the elderly: outcomes, safety and complications. Singapore Med J. 2005 Nov:46(11/621-6Demarquay JF, Dumas R, Buckley MJ. et al. Endoscopic retrograde cholangiopancreatography in patients with Billroth II gastrectomy Ital J Gastroenterol Hepatol. 1998 Jun;30(3):297-300.Demarquay JF, Dumas R, Buckley MJ. et al. Endoscopic retrograde cholangiopancreatography in patients with Billroth II gastrectomy Ital J Gastroenterol Hepatol. 1998 Jun;30(3):297-300.Elton E, Hanson BL, QaseemT, etal. Diagnostic and therapeutic ERCP using an enteroscope and a pediatric colonoscope in long-limb surgical bypass patients. Gastrointest Endosc 1998;47:62-7.Elton E, Hanson BL, QaseemT, etal. Diagnostic and therapeutic ERCP using an enteroscope and a pediatric colonoscope in long-limb surgical bypass patients. Gastrointest Endosc 1998;47:62-7.Emmett D., Mallat D. Endoscopic retrograde cholangiopancreatography using a double balloon endoscope in Roux-En-Y Surgical Bypass patients: a case series. Gastroint. Endosc. 2007 Vol.65 (5): AB236Emmett D., Mallat D. Endoscopic retrograde cholangiopancreatography using a double balloon endoscope in Roux-En-Y Surgical Bypass patients: a case series. Gastroint. Endosc. 2007 Vol.65 (5): AB236Faylona JM, Qadir A, Chan AC et al. Small-bowel perforations related to endoscopic retrograde cholangiopancreatography (ERCP) in patients with Billroth II gastrectomy. Endoscopy. 1999 Sep;31(7/546-9.Faylona JM, Qadir A, Chan AC et al. Small-bowel perforations related to endoscopic retrograde cholangiopancreatography (ERCP) in patients with Billroth II gastrectomy. Endoscopy. 1999 Sep;31(7/546-9.HaberG. B. Double balloon endoscopy for pancreatic and biliary access in altered anatomy. Gastrointest Endosc 2007;66(3):S47-50HaberG. B. Double balloon endoscopy for pancreatic and biliary access in altered anatomy. Gastrointest Endosc 2007;66(3):S47-50Hintze RE, Adler A, Veltzke W, et al. Endoscopic access to the papilla of Vater for endoscopic retrograde cholangiopancreatography in patients with Billroth II orRoux-en-Y gastrojejunostomy. Endoscopy 1997:29: 69-73.Hintze RE, Adler A, Veltzke W, et al. Endoscopic access to the papilla of Vater for endoscopic retrograde cholangiopancreatography in patients with Billroth II orRoux-en-Y gastrojejunostomy. Endoscopy 1997:29: 69-73.Kim MH, Lee SK, Lee MH et al. Endoscopic retrograde cholangiopancreatography and needle-knife sphincterotomy in patients with Billroth II gastrectomy: a comparative study of the forward-viewing endoscope and the side-viewing duodenoscope. Endoscopy. 1997 Feb;29(2):82-5,Kim MH, Lee SK, Lee MH et al. Endoscopic retrograde cholangiopancreatography and needle-knife sphincterotomy in patients with Billroth II gastrectomy: a comparative study of the forward-viewing endoscope and the side-viewing duodenoscope. Endoscopy. 1997 Feb;29(2):82-5,Larkin CJ, Huibregtse К Precut sphincterotomy: indications, pitfalls, and complications. Curr Gastroenterol Rep. 2001 Apr; 3(2): 147-53.Larkin CJ, Huibregtse К Precut sphincterotomy: indications, pitfalls, and complications. Curr Gastroenterol Rep. 2001 Apr; 3(2): 147-53.Lee YT. Cap-assisted endoscopic retrograde cholangiography in a patient with a Billroth II gastrectomy. Endoscopy 2004:36:666Lee YT. Cap-assisted endoscopic retrograde cholangiography in a patient with a Billroth II gastrectomy. Endoscopy 2004:36:666Lin LF, Siauw СР, Но KS, et al. ERCP in post-Billroth II gastrectomy patients: emphasis on technique. Am J Gastroenterol 1999; 94:144-8Lin LF, Siauw СР, Но KS, et al. ERCP in post-Billroth II gastrectomy patients: emphasis on technique. Am J Gastroenterol 1999; 94:144-8Mugica F, Urdapilleta G, Castiella A et al. Selective sphincteroplasty of the papilla in cases at risk due to atypical anatomy. World J Gastroenterol. 2007 Jun 14; 13(22):3106-11.Mugica F, Urdapilleta G, Castiella A et al. Selective sphincteroplasty of the papilla in cases at risk due to atypical anatomy. World J Gastroenterol. 2007 Jun 14; 13(22):3106-11.Nakahara K., Horaguchi J., Fujita N. et al. Therapeutic Endoscopic Retrograde Cholangiopancreaticography (ERCP) for Bile Duct Stones in Patients with a Prior Billroth II Gastrectomy. Gastroint. Endosc. 2007 Vol.65 (5): AB222Nakahara K., Horaguchi J., Fujita N. et al. Therapeutic Endoscopic Retrograde Cholangiopancreaticography (ERCP) for Bile Duct Stones in Patients with a Prior Billroth II Gastrectomy. Gastroint. Endosc. 2007 Vol.65 (5): AB222Osnes M, Rosseland A R, and Aabakken L Endoscopic retrograde cholangiography and endoscopic papillotomy in patients with a previous Billroth-ll resection. Gut. 1986 October; 27(10): 1193-1198.Osnes M, Rosseland A R, and Aabakken L Endoscopic retrograde cholangiography and endoscopic papillotomy in patients with a previous Billroth-ll resection. Gut. 1986 October; 27(10): 1193-1198.Park CH, Lee WS, Joo YE et al. Cap-assisted ERCP in patients with a Billroth II gastrectomy Gastrointest Endosc. 2007 Sep;66(3):612-5.Park CH, Lee WS, Joo YE et al. Cap-assisted ERCP in patients with a Billroth II gastrectomy Gastrointest Endosc. 2007 Sep;66(3):612-5.Schulz HJ, Bertullies M, Drossel R. ERCP after Billroth II gastrectomy. Digestive Disease Week 2003 http://www.endoscopy.ru/ view_news.html?id=6564Schulz HJ, Bertullies M, Drossel R. ERCP after Billroth II gastrectomy. Digestive Disease Week 2003 http://www.endoscopy.ru/ view_news.html?id=6564Schulz H.-J, Bertullies М., Kinzel E Biiiopankreatische Interventionen nach Magenresektionen. Endosk heute 2006; 19: 273-276Schulz H.-J, Bertullies М., Kinzel E Biiiopankreatische Interventionen nach Magenresektionen. Endosk heute 2006; 19: 273-276Swarnakar K, Stamatakis JD, Young WT. Diagnostic and therapeutic endoscopic retrograde cholangiopancreaticography after Billroth II gastrectomy-safe provision in a district general hospital. Ann R Coll Surg Engl. 2005 Jul;87(4):274-6.Swarnakar K, Stamatakis JD, Young WT. Diagnostic and therapeutic endoscopic retrograde cholangiopancreaticography after Billroth II gastrectomy-safe provision in a district general hospital. Ann R Coll Surg Engl. 2005 Jul;87(4):274-6.Takahashi K., Maguchi H., Katanuma A. et al. Diagnostic and therapeutic ERCP for patients with Billrot II reconstraction. Endoscopy 2006; 38 (Suppl. II) A234Takahashi K., Maguchi H., Katanuma A. et al. Diagnostic and therapeutic ERCP for patients with Billrot II reconstraction. Endoscopy 2006; 38 (Suppl. II) A234Tanaka S, Mitsui K, Tatsuguchi A, et al. Usefulness of doubleballoon endoscopy for diagnosis and treatment of the post-operative gastrointestinal tract [abstract], Gastrointest Endosc 2006;63:AB291Tanaka S, Mitsui K, Tatsuguchi A, et al. Usefulness of doubleballoon endoscopy for diagnosis and treatment of the post-operative gastrointestinal tract [abstract], Gastrointest Endosc 2006;63:AB291Will U, Thieme A, Fueldner Fetal. Treatment of biliary obstruction in selected patients by endoscopic ultrasonography (EU'S)-guided transluminal biliary drainage. Endoscopy. 2007Apr;39(4):292-5. Epub 2007 Mar 15.Will U, Thieme A, Fueldner Fetal. Treatment of biliary obstruction in selected patients by endoscopic ultrasonography (EU'S)-guided transluminal biliary drainage. Endoscopy. 2007Apr;39(4):292-5. Epub 2007 Mar 15.Wright BE, Cass OW, Freeman ML ERCP in patients with long-limb Roux-en-Y gastrojejunostomy and intact papilla. Gastrointest Endosc. 2002 Aug;56(2):225-32.Wright BE, Cass OW, Freeman ML ERCP in patients with long-limb Roux-en-Y gastrojejunostomy and intact papilla. Gastrointest Endosc. 2002 Aug;56(2):225-32.

The authors declare that there are no conflicts of interest present.