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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 소화기인터벤션의학회 International Journal of Gastrointestinal Intervention International Journal of Gastrointestinal Intervention 제7권 제2호
- 발행연도
- 2018.1
- 수록면
- 74 - 77 (4page)
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Endoscopic management is presently the recommended first-line of treatment for biliary strictures. However, surgery still has an important role especially for biliary obstruction (BO) with duodenal obstruction. Even though endoscopic treatment for concurrent BO and gastric-outlet obstruction has been proposed, it is still not widespread. Duodenal obstruction is often associated with malignant BO which makes endoscopic treatment more challenging. Biliary and gastrointestinal double bypass with Roux-en-Y hepaticojejunostomy and gastrojejunostomy is the most common surgical intervention for malignant biliary and gastric-outlet obstruction. A variety of procedures of biliary bypass and gastrointestinal bypass have been reported. According to several studies, mortality rates range from 0% to 7%, while morbidity rates range from 3% to 50%. Higher morbidity was observed in symptomatic patients caused by the disease. Most common morbidity after double bypass was delayed gastric emptying. Recurrence of BO and gastric-outlet obstruction was less frequently seen after surgical bypass compared to after endoscopic treatment. Minimally invasive approach has been applied to double bypass. Studies showed that laparoscopic double bypass has a shorter hospital stay and reduced postoperative pain; however, due to its technical demand, it is still presently an uncommon procedure. Robotic bypass surgery may resolve this issue in the future. Further analyses of outcomes of both surgical and endoscopic treatments are necessary to establish better and suitable palliation options for concurrent biliary and duodenal obstruction caused by unresectable malignant tumors.
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참고문헌 (34)
참고문헌 신청
Brewer Gutierrez OI / 2017 / Double endoscopic bypass for gastric outlet obstruction and biliary obstruction / Endosc Int Open 5:E893~E899
Hamada T / 2018 / International study of endoscopic management of distal malignant biliary obstruction combined with duodenal obstruction / Scand J Gastroenterol 53:46~55
Nakai Y / 2017 / Endoscopic management of combined malignant biliary and gastric outlet obstruction / Dig Endosc 29:16~25
Tol JA / 2015 / Non-radical resection versus bypass procedure for pancreatic cancer : a consecutive series and systematic review / Eur J Surg Oncol 41:220~227
Tempero MA / 2017 / Pancreatic adenocarcinoma, version 2.2017, NCCN clinical practice guidelines in oncology / J Natl Compr Canc Netw 15:1028~1061
Hamada T / 2018 / International study of endoscopic management of distal malignant biliary obstruction combined with duodenal obstruction / Scand J Gastroenterol 53:46~55
Nakai Y / 2017 / Endoscopic management of combined malignant biliary and gastric outlet obstruction / Dig Endosc 29:16~25
Tol JA / 2015 / Non-radical resection versus bypass procedure for pancreatic cancer : a consecutive series and systematic review / Eur J Surg Oncol 41:220~227
Tempero MA / 2017 / Pancreatic adenocarcinoma, version 2.2017, NCCN clinical practice guidelines in oncology / J Natl Compr Canc Netw 15:1028~1061
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