{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T07:46:23Z","timestamp":1697183183737},"reference-count":40,"publisher":"Georg Thieme Verlag KG","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Gastroenterol"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Ziel\u2002Untersuchung von Machbarkeit und Outcome EUS-gest\u00fctzter Steinextraktionstechniken \u00fcber einen transhepatischen Zugang bei Patienten mit postoperativ modifizierter Anatomie.<\/jats:p><jats:p>Material\/Methoden\u2002Alle konsekutiven Patienten (Pat.) mit Cholangiolithiasis und operativ ver\u00e4nderter Anatomie nach ggf. frustranem ERC-Versuch wurden in diese monozentrische Fallstudie eingeschlossen und bzgl. des technischen\/klinischen Erfolgs charakterisiert.<\/jats:p><jats:p>Ergebnisse\u2002Von 2004 bis 03\/2020 wurden bei 449 Pat. EUS-gest\u00fctzte Gallenwegdrainagen durchgef\u00fchrt (n\u200a=\u200a37 Pat. mit Cholangiolithiasis). Bei 8 der 37 Pat. erfolgte die Steinextraktion in EUS-ERCP-Rendezvoustechnik (kein Bestandteil der Studie, da keine operativ ver\u00e4nderte Anatomie vorlag). Bei 13 der verbleibenden 29 Pat. (45\u200a%) wurden im Vorfeld frustrane Versuche der ballonenteroskopischen ERCP bei fehlender Erreichbarkeit der Papilla Vateri bzw. der biliodigestiven Anastomose unternommen. Der EUS-gest\u00fctzte Zugang zu den Gallenwegen gelang bei allen 29 Pat. Die Steinextraktion erfolgte bei 26 Pat. (90\u200a%) in antegrader Push-Technik nach vorheriger Ballondilatation der Papilla Vateri beziehungsweise der biliodigestiven Anastomose. Bei 11 Pat. (42\u200a%) erfolgte nachfolgend zur Schienung der Papilla Vateri\/biliodigestiven Anastomose die Einlage einer Doppelpigtailprothese (\u201eRingdrainage\u201c), die in der Regel nach 3 Monaten nach vorheriger sonografischer und laborchemischer Kontrolle mittels Gastroskopie wieder entfernt wurde. Bei 2 Pat. (7\u200a%) erfolgte die Steinextraktion retrograd \u00fcber den transhepatischen Zugang, bei 1 Pat. (3\u200a%) wurde die Steinextraktion kombiniert in antegrader und retrograder Technik vorgenommen. Bei 2 Pat. (7\u200a%) kam eine Cholangioskopie mit elektrohydraulischer Lithotripsie zum Einsatz.<\/jats:p><jats:p>Die technische und klinische Erfolgsrate der Steinextraktion lag bei 100\u200a% (29 von 29 Pat.). Re-Interventionen erfolgten bei 6 Pat. (21\u200a%), Komplikationen traten bei 6 Pat. (21\u200a%) auf.<\/jats:p><jats:p>Schlussfolgerung\u2002Die EUS-gest\u00fctzte Steinextraktion in antegrader oder retrograder Technik bei Patienten mit operativ ver\u00e4nderter Anatomie ist eine sichere, wenn auch technisch anspruchsvolle Methode der interventionellen Endoskopie\/EUS.\u200aSie hat eine hohe technische und klinische Erfolgsrate und eine niedrige Komplikationsrate. Sie hat das Potenzial, die zeitaufwendige ERCP mit Ballon-Enteroskopen und v.\u200aa. auch die PTCD und somit sekund\u00e4re und terti\u00e4re Therapiealternativen zu ersetzen.<\/jats:p>","DOI":"10.1055\/a-1250-8834","type":"journal-article","created":{"date-parts":[[2020,11,16]],"date-time":"2020-11-16T23:39:52Z","timestamp":1605569992000},"page":"1081-1090","source":"Crossref","is-referenced-by-count":0,"title":["Endosonografisch gest\u00fctzteTherapie der Cholangiolithiasis bei chirurgisch ver\u00e4nderter Anatomie \u2013 eine monozentrische Fallstudie"],"prefix":"10.1055","volume":"58","author":[{"given":"Frank","family":"Fueldner","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gastroenterologie, Hepatologie und Allgemeine Innere Medizin, SRH Wald-Klinikum Gera gGmbH, Gera;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Meyer","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik f\u00fcr Allgemein-, Viszeral-, Gef\u00e4\u00df- und Transplantationschirurgie, Universit\u00e4tsklinikum Magdeburg A.\u00f6.R. Magdeburg; Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uwe","family":"Will","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gastroenterologie, Hepatologie und Allgemeine Innere Medizin, SRH Wald-Klinikum Gera gGmbH, Gera;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,11,16]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"150","DOI":"10.4103\/1319-3767.207713","article-title":"Endoscopic retrograde cholangiopancreatography with double balloon enteroscope in patients with altered gastrointestinal anatomy: A meta-analysis","volume":"23","author":"X D Shao","year":"2017","journal-title":"Saudi J Gastroenterol"},{"issue":"S 01","key":"ref2","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1111\/den.13022","article-title":"Endoscopic management of bile duct stones in patients with surgically altered anatomy","volume":"30","author":"Y Nakai","year":"2018","journal-title":"Dig Endosc"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"E1417","DOI":"10.1055\/a-0754-2290","article-title":"Usefulness of the \u201cnewly designed\u201d short-type single-balloon enteroscope for ERCP in patients with Roux-en-Y gastrectomy: a pilot study","volume":"06","author":"Y Tanisaka","year":"2018","journal-title":"Endosc Internat Open"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1007\/s12328-014-0505-3","article-title":"Endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy using balloon-assisted enteroscope","volume":"7","author":"A Katanuma","year":"2014","journal-title":"Clin J Gastroenterol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1055\/s-2007-1004077","article-title":"Endoscopic access to the papilla of Vater for endoscopic retrograde cholangiopancreatography in patients with billroth II or Roux-en-Y gastrojejunostomy","volume":"29","author":"R E Hintze","year":"1997","journal-title":"Endoscopy"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/S0016-5107(02)70182-X","article-title":"ERCP in patients with long limb Roux-en-Y gastrojejunostomy and intact papilla","volume":"56","author":"B E Wright","year":"2002","journal-title":"Gastrointest Endosc"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1055\/s-2006-945003","article-title":"Endoscopic retrograde cholangiopancreatography in post-Whipple patients","volume":"38","author":"P Chahal","year":"2006","journal-title":"Endoscopy"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/S0016-5107(98)70300-1","article-title":"Diagnostic and therapeutic ERCP using an enteroscope and a pediatric colonoscope in long-limb surgical bypass patients","volume":"47","author":"E Elton","year":"1998","journal-title":"Gastrointest Endosc"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.gie.2007.06.017","article-title":"Double balloon endoscopy for pancreatic and biliary access in altered anatomy (with videos)","volume":"66","author":"G B Haber","year":"2007","journal-title":"Gastrointest Endosc"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1016\/j.gie.2007.04.030","article-title":"ERCP plus papillotomy by use of double-balloon enteroscopy after Billroth II gastrectomy","volume":"66","author":"Y C Chu","year":"2007","journal-title":"Gastrointest Endosc"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1067\/mge.2002.120385","article-title":"Endoscopy and ERCP in the setting of previous upper GI tract surgery. 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