| Revista: | Acta gastroenterológica latinoamericana |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000321433 |
| ISSN: | 0300-9033 |
| Autores: | Artifon, Everson L.A1 Couto-Junior, Decio S1 Navarro, Alex1 |
| Instituciones: | 1Universidade de Sao Paulo, Sao Paulo. Brasil |
| Año: | 2009 |
| Periodo: | Mar |
| Volumen: | 39 |
| Número: | 1 |
| Paginación: | 19-23 |
| País: | Argentina |
| Idioma: | Español |
| Tipo de documento: | Artículo |
| Enfoque: | Caso clínico, analítico |
| Resumen en español | éxito de esta técnica fue de 83.8% (31 de 37 casos) y la técnica fue considerada como un método seguro y eficiente en pacientes con Billroth II y canulación difícil de la papila, con fracaso de la técnica de canulación convencional |
| Resumen en inglés | diagnostic and therapeutic ERCP in patients with Billroth II gastrectomy is a challenging procedure due to anatomic alterations. New accessories and techniques were developed in order to minimize these adversities. Aim: a new technique for biliary access in patients with Billroth II gastrectomy. Patients: In the period from February 2003 to August 2007, 257 ERCP presented Billroth II gastrectomy and choledocolithiasis. In 37 of these patients catheterization by conventional technique was not possible and they were submitted to the new technique. Methods: after fistulotomy in order to access CBD, a 0.035-inch guidewire was passed followed by an 8-mm dilator biliary balloon which was settled in transpapillary position. Through the working channel the knedle-knife was passed which when positioned in front of the papilla allowed the section of the sphincter over the balloon infflated with contrast until waist disappearance on radioscopy. Results: of the 37 patients submitted to the new procedure six were excluded. Sixteen patients (61.6%) were female and fifteen (48.4%) male. Age ranged from 29 to 89 years with a mean of 62.3 years. All patients had jaundice by clinical and laboratory tests. Time of procedure varied from 18 to 48 minutes (30 minutes). Diameter of the bile duct was 4.5 to 12.8 mm (7.7 mm) presenting one to seven calculi. There were occurred six (19.3%) complications related to the procedure, three (9.7%) pancreatitis, two (6.4%) hemorrhages and one (3.2%) perforation. There were no procedure-related deaths. Conclusion: success of this technique was 83.8% (31 of the 37 cases); therefore the technique is considered a safe and efficient method in patients with Billroth II and difficult duodenal papilla cannulation and it was previously attempted by means of conventional cannulation technique |
| Disciplinas: | Medicina |
| Palabras clave: | Cirugía, Gastroenterología, Esfinterotomía, Canulación, Cateterismo, Vías biliares, Endoscopia, Técnicas quirúrgicas |
| Keyword: | Medicine, Gastroenterology, Surgery, Sphincterotomy, Catheterization, Biliary tract, Endoscopy, Surgical techniques |
| Texto completo: | Texto completo (Ver PDF) |
