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| 1 | 无痛胃镜在不同人群中的应用进展显示文摘内镜诊疗技术因其诊断准确,创伤小,恢复快,已成为临床诊疗工作中不可缺少的重要诊疗手段。电子胃镜虽然有普通胃镜、无痛胃镜、笑气胃镜,但在诊治舒适度方面,还是要推崇无痛胃镜。它具有较好的安全性和舒适性,是当今世界上流行的胃镜诊疗方式,适合在更多的人群中开展。目前,无痛胃镜在不同年龄、不同医院、不同收入人群中的应用有所不同。 | 蒋远洪 谭友果 | 2015 | 中国内镜杂志2015，21，2： | 29 |
| 2 | Endoscopic management of biliary strictures after liver transplantation显示文摘Bile duct strictures remain a major source of morbidity after orthotopic liver transplantation (OLT). Biliary strictures are classifi ed as anastomotic or non-anastomotic strictures according to location and are defi ned by distinct clinical behaviors. Anastomotic strictures are localized and short. The outcome of endoscopic treatment for anastomotic strictures is excellent. Nonanastomotic strictures often result from ischemic and immunological events, occur earlier and are usually multiple and longer. They are characterized by a far less favorable response to endoscopic management, higher recurrence rates, graft loss and need for retransplantation. Living donor OLT patients present a unique set of challenges arising from technical factors, and stricture risk for both recipients and donors. Endoscopic treatment of living donor OLT patients is less promising. Current endoscopic strategies for biliary strictures after OLT include repeated balloon dilations and placement of multiple side-by-side plastic stents. Lifelong surveillance is required in all types of strictures. Despite improvements in incidence and long term outcomes with endoscopic management, and a reduced need for surgical treatment, the impact of strictures on patients after OLT is signifi cant. Future considerations include new endoscopic technologies and improved stents, which could potentially allow for a decreased number of interventions, increased intervals before retreatment, and decreased reliance on percutaneous and surgical modalities. This review focuses on the role of endoscopy in biliary strictures, one of the most common biliary complications after OLT. | Emmanuelle D Williams Peter V Draganov | 2009 | World Journal of Gastroenterology2009，15，30： | 20 |
| 3 | Per oral cholangiopancreatoscopy in pancreatico biliary diseases- Expert consensus statements显示文摘AIM: To provide consensus statements on the use of per-oral cholangiopancreatoscopy(POCPS).METHODS: A workgroup of experts in endoscopic retrograde cholangiopancreatography(ERCP), endosonography, and POCPS generated consensus statements summarizing the utility of POCPS in pancreaticobiliary disease. Recommendation grades used validated evidence ratings of publications from an extensive literature review.RESULTS: Six consensus statements were generated:(1) POCPS is now an important additional tool during ERCP;(2) in patients with indeterminate biliary strictures, POCS and POCS-guided targeted biopsy are useful for establishing a definitive diagnosis;(3) POCS and POCS-guided lithotripsy are recommended for treatment of difficult common bile duct stones when standard techniques fail;(4) in patients with main duct intraductal papillary mucinous neoplasms(IPMN) POPS may be used to assess extent of tumor to assist surgicalresection;(5) in difficult pancreatic ductal stones,POPS-guided lithotripsy may be useful in fragmentation and extraction of stones; and(6) additional indications for POCPS include selective guidewire placement,unexplained hemobilia, assessing intraductal biliary ablation therapy, and extracting migrated stents. CONCLUSION: POCPS is important in association with ERCP, particularly for diagnosis of indeterminate biliary strictures and for intra-ductal lithotripsy when other techniques failed, and may be useful for preoperative assessment of extent of main duct IPMN, for extraction of difficult pancreatic stones, and for unusua indications involving selective guidewire placement,assessing unexplained hemobilia or intraductal biliary ablation therapy, and extracting migrated stents. | Mohan Ramchandani Duvvur Nageshwar Reddy Sundeep Lakhtakia Manu Tandan Amit Maydeo Thoguluva Seshadri Chandrashekhar Ajay Kumar Randhir Sud Rungsun Rerknimitr Dadang Makmun Christopher Khor | 2015 | World Journal of Gastroenterology2015，21，15： | 8 |
| 4 | ampullary 腺瘤的诊断和管理: 内视镜检查法的膨胀角色显示文摘 Ampullary adenoma is a pre-cancerous lesion arising from the duodenal papilla that is often asymptomatic.It is important to distinguish whether the adenoma is sporadic or arises in the setting of familial adenomatous polyposis as this has important implications with respect to management and surveillance.Multiple modalities are available for staging of these lesions to help guide the most appropriate therapy.Those that are used most commonly include computed tomography,endoscopic ultrasound,and endoscopic retrograde cholangiopancreatography.In recent years,endoscopy has become the primary modality for therapeutic management of the majority of ampullary adenomas.Surgery remains the standard curative procedure for confirmed or suspected adenocarcinoma.This review will provide the framework for the diagnosis and management of ampullary adenomas from the perspective of the practicing gastroenterologist. | Payam Chini Peter V Draganov | 2011 | World Journal of Gastrointestinal Endoscopy2011，3，12： | 7 |
| 5 | 新型子母镜诊治胆胰疾病的临床应用显示文摘经十二指肠内镜逆行胰胆管造影术(ERCP)是诊断胆胰管病变常用方法,但因不能区别病变的良恶性使其应用受到限制。1974年,胆胰管造影影像系统的发展促进了疾病病理诊断的进步。然而,子镜的结构和操作困难的相关技术问题及方便胰管活组织检查工作通道的缺乏使它的临床应用和普及受到限制。近来,我院采用了德国铂立公司的超细胆胰管镜影像系统。这种新型子镜系统有更细的外径,通过小切口或柱状气囊扩张就很容易插入,更易于操作。这种高分辨率的可调节操控镜身的子镜系统能最大范围直视胆胰管病变,有足够的工作孔道便于治疗操作,如肝内胆管结石的取石,支架的放置及药物注射等,有足够的工作孔道便于治疗操作,如肝内胆管结石的取石,支架的放置及药物注射等。通过临床10例患者的应用实践,总结治疗方法,包括适应证和禁忌证、术后并发症如急性胰腺炎,组织损伤导致的出血和胆汁瘘等。目前,我们正在不断探索这种新型子镜系统的临床效果,改进操作技术以提高子镜可操控性,同时开展液电或激光石碎石的有效应用,以减少组织损伤和降低住院费用。 | 王蒙 王广义 张小博 杜晓宏 | 2013 | 临床肝胆病杂志2013，29，3： | 6 |
| 6 | 腹腔镜联合术中胆道镜经胆囊管治疗胆总管继发性结石32例报道显示文摘目的探讨腹腔镜下经胆囊管胆道镜治疗胆总管继发性结石的适应症及方法.方法对32例腹腔镜下经胆囊管胆道镜治疗的继发性胆总管结石资料进行回顾性分析,并与同期进行的腹腔镜下胆总管切开探查、T管引流组进行比较.结果全组顺利完成,无并发症出现.与对照组相比,在术后住院时间、住院费用方面具有明显优势.结论对于符合条件的继发性胆总管结石患者,腹腔镜下经胆囊管胆道镜取石者结果明显优于胆总管切开取石,T管引流者.MRCP检查对手术适应症的判断及对手术操作具有指导作用. | 和红春 杜锐锋 李晗宇 张冰 陈焰 杜云飞 | 2014 | 昆明医科大学学报2014，35，5： | 4 |
| 7 | SpyGlass系统对不明原因胆道狭窄的诊断价值显示文摘胆道狭窄是常见的消化系统疾病,随着医疗水平的发展,腹部超声、肝胆系统CT、磁共振胰胆管造影(MRCP)已成为基础性的检查方法。20世纪60年代随着经内镜逆行性胰胆管造影术(ERCP)的问世,ERCP在胆道狭窄的诊断中占有举足轻重的地位,但仍然存在区分良恶性狭窄准确度低、病理活检取材欠理想等局限性。 | 郭蕊 王拥军 | 2017 | 医学临床研究2017，34，1： | 3 |
| 8 | 胆道镜治疗胆道结石常见问题分析显示文摘目的分析胆道镜治疗胆道结石时碰到的问题和常见的失败原因以及改进方法。方法对2005年1月~2008年9月期间的762例曾经使用纤维胆道镜术中治疗胆道结石的病例进行分析和总结。结果703例患者中,136例术后有胆道结石残留,残余结石率为17.8%,其中术中已知结石残留55例,术后经T管造影和术后胆道镜证实有结石残留81例。81例中包括肝内胆管结石伴胆管开口狭窄29例,肝内胆管结石伴胆管变异39例,胆总管下段节段性狭窄伴结石13例。结论术中胆道镜治疗胆道结石时要注意有无胆道变异和病变胆管开口狭窄或胆总管下端节段性狭窄等情况,术中B超对降低结石漏诊率有帮助。在使用纤维胆道镜时,术者要耐心细致,按顺序逐支逐段地检视,对胆道应采用连续窥视的方法和导向钳夹法以尽量避免主观和客观因素引起的术后结石残留。 | 苏久林 | 2009 | 齐齐哈尔医学院学报2009，30，8： | 3 |
| 9 | 经口胆道子母镜碎石治疗胆管巨大嵌顿性结石21例显示文摘目的探讨经口胆道子母镜液电联合机械碎石治疗胆管巨大嵌顿性结石的可行性。方法常规经内镜逆行胰胆管取石(ERCP)治疗困难的胆管巨大嵌顿性结石患者21例,用子母镜液电先将结石击散,再⒚机械碎石网篮碎清除结石。结果21例患者子母镜取石治疗均获成功。18例肝外胆管结石中14例一次性取净结石,4例两次取净结石。3例左右肝管嵌顿结石病例,2例取净结石;1例合并右肝内胆管多发嵌顿结石,未能取净结石。术中短暂出血3例,术后胆管炎1例,术后胰腺炎2例,无穿孔、死亡等严重并发症。结论对常规ERCP治疗困难的胆管巨大嵌顿性结石,子母镜液电联合机械碎石是一种安全和有效的办法。 | 庞勇 田伏洲 张炳印 汤礼军 | 2010 | 中华普通外科学文献(电子版)2010，4，1： | 3 |
| 10 | 应用胆胰管内窥镜经胆囊管胆道探查21例临床分析显示文摘目的探讨应用胆胰管内窥镜经胆囊管行胆道探查的临床应用价值。方法 2011年1月~2012年1月,对21例急、慢性结石性胆囊炎合并或可疑合并肝内外胆管结石者,在开腹胆囊切除术中应用德国PolyDiagnost公司组合式、软性、可旋转纤维内窥镜(外径F8)经胆囊管行胆道探查、取石。结果 2例肝内胆管结石,用套石篮顺利取出。胆总管结石14例,其中6例经胆囊管顺利取出,4例钬激光击碎结石取出,2例行胆囊管汇入胆总管处微切开取石,未成功2例,行传统胆总管切开取石T管引流。5例未见明显结石及十二指肠乳头狭窄。术后胆漏1例,无胆道残余结石等并发症发生。术后随访6~18个月,平均13个月,无结石复发。结论应用胆胰管内窥镜经胆囊管进行肝内外胆管探查,避免了胆总管切开和放置T管,提高了胆道结石诊断的准确率,是一种安全简便、创伤小、恢复快的方法。 | 李春生 王廷峰 张箭平 刘进军 闵志均 | 2012 | 中国微创外科杂志2012，12，12： | 2 |
| 11 | 子母镜下治疗胆管巨大嵌顿性结石21例分析显示文摘我院自2006年7月至2008年12月应用经口胆道子母镜液电碎石联合一体化机械碎石对21例十二指肠镜下常规ERCP治疗困难的肝内外胆管巨大嵌顿性结石进行了治疗,效果满意,报道如下. | 庞勇 张炳印 汤礼军 田伏洲 | 2010 | 中华消化内镜杂志2010，27，6： | 1 |
| 12 | 肝移植术后胆管狭窄的内镜治疗进展显示文摘胆管狭窄是肝移植术后最常见的并发症之一,也是导致肝移植受体病残和死亡的一个重要原因。根据狭窄发生的部位和不同的临床表现,胆管狭窄可分为吻合口狭窄和非吻合口狭窄。目前内镜治疗肝移植术后胆管狭窄的策略包括反复球囊扩张和多根并排塑料支架置入。吻合口狭窄常局限于胆管吻合区域呈短节段,内镜球囊扩张和支架置入可成功治疗大多数肝移植术后胆管吻合口狭窄患者。非吻合口狭窄常由于缺血和免疫损伤所致,发生较早,通常多发且呈长节段。非吻合口狭窄对内镜治疗反应不佳,复发率高,常出现供肝失效需要再次肝移植。内镜治疗肝移植术后胆管狭窄的未来方向包括更先进的内镜,全新的操作技术以及改良的支架应用于临床,从而减少内镜介入治疗的次数,延长胆管通畅时间,减少对经皮经肝途径和外科手术的依赖。 | 庞勇 田伏洲 | 2011 | 实用医院临床杂志2011，8，6： | 0 |
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