Upper gastrointestinal endoscopy in the surgically altered patient.

Autor: Bhat P; Gastroenterology and Hepatology Unit, Canberra Hospital, Canberra, Australia.; College of Health and Medicine, Australian National University, Canberra, Australia., Kaffes AJ; Interventional Endoscopy, Chris O'Brien Lifehouse, Sydney, Australia.; AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, Australia.; Department of Medicine, University of Sydney, Sydney, Australia., Lassen K; Department of HPB Surgery, Oslo University Hospital, Oslo, Norway.; Institute of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway., Aabakken L; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.; Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.
Jazyk: angličtina
Zdroj: Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society [Dig Endosc] 2024 Oct; Vol. 36 (10), pp. 1077-1093. Date of Electronic Publication: 2024 Jul 01.
DOI: 10.1111/den.14823
Abstrakt: As management of upper gastrointestinal malignancies improves, and with popularization of bariatric surgery, endoscopists are likely to meet patients with altered upper gastrointestinal anatomy. Short-term, the surgery can cause complications like bleeding, leaks, and fistulas, and longer-term problems such as intestinal or biliary anastomotic strictures or biliary stones can arise, all necessitating endoscopy. In addition, the usual upper gastrointestinal pathologies can also still occur. These patients pose unique challenges. To proceed, understanding the new layout of the upper gastrointestinal tract is essential. The endoscopist, armed with a clear plan for navigation, can readily diagnose and manage most commonly occurring conditions, such as marginal ulcers and proximal anastomotic strictures with standard endoscopic instruments. With complex reconstructions involving long segments of small bowel, such as Roux-en-Y gastric bypass, utilization of balloon-assisted enteroscopy may be necessary, mandating modification of procedures such as endoscopic retrograde cholangiopancreatography. Successful endoscopic management of patients with altered anatomy will require prior planning and preparation to ensure the appropriate equipment, setting, and skill set is provided.
(© 2024 The Authors. Digestive Endoscopy published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society.)
Databáze: MEDLINE
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