ERCPにおけるStretching Methodと超広視野角十二指腸ファイバースコープの併用について

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タイトル別名
  • STRETCHING METHOD WITH SUPER-WIDE-VIEWING DUODENOSCOPE IN ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY

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説明

Endoscopic retrograde cholangiopancreatography (ERCP) is a widely used technique for diagnosis of pancreatobiliary diseases. However, selective visualization of the biliary tract by means of ERCP is not necessarily easy. The purpose of this study is to investigate the usefulness of the adoptation of stretch-ing method with super-wide-viewing duodenoscope in ERCP. Super-wide-viewing duodenoscope with 105° of view angle (DUO-X, Fujinon) was used in 149 ERCP examinations and relatively narrow-viewing duodenoscope with 64° (JF-B3, Olympus) in 87 examinations. The rate of successful selective visualization of the bile duct with DUO-X was higher than that with JF-B3 (93.5% compared to 77.8%), on the contrary those of the pancreatic duct with both instruments were equivalent (97.0% and 96.8%, respectively). The result of selective cholangiography in the 61 ERCP examinations, in which stretching technique with DUO-X was introduced, was significantly (p <0.01) superior to that in the 45 examinations by means of pushing method with JF-B3 (Rate of success was 96.7% compared to 77.3%). The mean examining time of selective cholangiography with stretching method and DUO-X combination in successful 30 cases was 11 minutes and 24 seconds. Stretching of the duodenoscope could be performed easily in the majority of the examined cases except for a few with markedly ptotic or severely deformed stomach. In conclusion, the combination of stretching technique and super-wide-viewing duodenoscope is an excellent method for selective cholangiography in ERCP.

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