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Z Gastroenterol 2022; 60(11): 1635-1643
DOI: 10.1055/a-1744-6738
Originalarbeit

Ergebnisse der motorisierten Spiralenteroskopie des Dünndarms an 83 konsekutiven Patienten

Results of motorized spiral enteroscopy in 83 consecutive patients
Hendrik Buchholz
1   Gastroenterology, Sana Klinikum Lichtenberg, Berlin, Germany (Ringgold ID: RIN40656)
,
Matthias Mende
1   Gastroenterology, Sana Klinikum Lichtenberg, Berlin, Germany (Ringgold ID: RIN40656)
,
Steffen Hornoff
1   Gastroenterology, Sana Klinikum Lichtenberg, Berlin, Germany (Ringgold ID: RIN40656)
,
Siegbert Faiss
1   Gastroenterology, Sana Klinikum Lichtenberg, Berlin, Germany (Ringgold ID: RIN40656)
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Zusammenfassung

Einleitung Zu der motorisierten Spiralenteroskopie des Dünndarms gibt es bislang nur wenige Daten. Wir berichten über unsere frühen Erfahrungen mit dieser Methode basierend auf einer retrospektiven Fallserie. Die vorliegende Fallserie an 83 konsekutiven Patienten ist die weltweit vierte Fallserie, die über die Ergebnisse bei 68 Dünndarm-Enteroskopien und bei 15 Enteroskopien/ERCPs bei Patienten mit voroperiertem Situs berichtet.

Patienten und Methoden Die retrospektive Single-center-Studie wurde von 01/2020 bis 09/2021 an 83 konsekutiven Patienten durchgeführt. Indikationen waren entweder bekannte oder vermutete Erkrankungen des Dünndarms oder Erkrankungen der Gallenwege bzw. des Pankreasganges bei mit Roux-Y-Anastomosen voroperierten Patienten.

Ergebnisse Bei 68 Patienten mit der Indikation zur Dünndarmenteroskopie (38 m; 30 w; mittleres Alter 66,4 J) ergab sich eine diagnostische Genauigkeit von 86,8% bei einem therapeutischen Erfolg von 41,2%. Die mittlere Eindringtiefe in den Dünndarm lag bei 279 cm bei einer mittleren Untersuchungszeit von 64,3 min. Bei 13 Patienten (19,7%) konnte eine Panenteroskopie durchgeführt werden. Bei nicht abdominell voroperierten Patienten lag die Rate intendierter kompletter Enteroskopien bei 46,2%.

Bei 15 Patienten (9 m; 6 w; mittleres Alter 61,8 J) mit postoperativ veränderter Anatomie und Anlage einer Roux-Y-Anastomose lag die Rate der Erreichbarkeit der Papille bzw. einer biliodigestiven Anastomose bei 60%.

Im gesamten Kollektiv betrug die Komplikationsrate 15,7%. Major-Komplikationen wie z.B. Perforationen oder interventionspflichtige Blutungen traten nicht auf.

Diskussion Unsere Fallserie zeigt, dass mit der motorisierten Spiralenteroskopie eine hohe Panenteroskopierate des Dünndarms erreicht werden kann. Zudem sind die hierfür benötigten Untersuchungszeiten relativ kurz. Größere und vor allem vergleichende Studien müssen hier wie bei den ebenfalls gezeigten ermutigenden Daten zu ERCPs bei mit einer Roux-Y-Anastomose voroperierten Patienten abgewartet werden.

Abstract

Introduction For motorized spiral enteroscopy, only limited data are available. We report about our early experiences with the motorized spiral enteroscopy in a retrospective case series. The present worldwide study reported the results of motorized spiral enteroscopy in 68 patients with small bowel diseases and in 15 patients with ERCP and surgically altered anatomy.

Patients and methods This retrospective single-centre study was performed between 01/2020 and 09/2021 in 83 consecutive patients. Indications were known or suspected small bowel diseases or diseases of the bile or pancreatic duct after surgical altered anatomy with Roux-Y anastomosis.

Results In 68 patients (38 m/30 f; mean age 66.4 years) with an indication for small bowel enteroscopy, diagnostic and therapeutic yield was 86.8% and 41.2%, respectfully. The average depth of maximum insertion was 279 cm with an average insertion time of 64.3 min. In 13 patients (19.7%), complete panenteroscopy was achieved. In patients without prior abdominal surgery, the rate of complete enteroscopy was 46.2%.

In 15 patients (9 m; 6 f; mean age 61.8 years) with surgically altered anatomy and Roux-Y anastomosis (the papilla resp.), the biliodigestive anastomosis could be reached in 60%.

In the entire case series, the total complication rate was 15.7%. There were no severe complications, such as perforation or major bleeding.

Discussion The present case series shows a high rate of panenteroscopies with a short examination time. To confirm these data, further comparative studies for ERCPs in patients with surgically altered anatomy are necessary.

Schlüsselwörter

Enteroskopie bei Dünndarmerkrankungen - motorisierte Spiralenteroskopie - Panenteroskopie - ERCP bei voroperierten Patienten mit Roux-Y Anastomose

Keywords

Enteroscopy in small bowel diseases - motorized spiral-enteroscopy - panenteroscopy - ERCP in surgically altered anatomy with Roux-Y anastomosis


Publication History

Received: 27 November 2021

Accepted after revision: 14 January 2022

Article published online:
17 February 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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