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Objective To evaluate the clinical effects and safety of double-channel forward-view endoscopy for lower-position biliary obstruction after Billroth-Ⅱ gastrectomy.Methods A total of 18 patients with lower-position biliary obstruction after Billroth-Ⅱ gastrectomy were enrolled and treated with doublechannel forward-view endoscopy.The process and the outcomes were recorded.Effectiveness and safety were evaluated.Results Double-channel forward-view endoscopic treatment was successfully performed in 13 of the 18 patients (72％),with stone removal or stents implantion to resolve biliary obstruction.The procedure failed in 5 patients,who were transferred to surgery or underwent percutaneous transhepatic cholangial drainage.Delayed bleeding occurred in 1 patient,and pancreatitis in 2,who were cured after standard treatments.Conclusion Double-channel forward-view endoscopy is effective and safe for lower-position biliary obstruction in patients after Billroth-Ⅱ gastrectomy.
RESUMO
Objective To discuss the effect of Billroth Ⅱ gastrectomy on glucose metabolism in patients with gastric cancer complicated with type 2 diabetes mellitus(T2 DM).Methods A retrospective study on the serum level of glucose in 7 patients with gastric cancer complicated with T2 DM undergone Billroth Ⅱ gastrectomy.The therapeutic regime for T2DM after the operation was also analyzed.Results Billroth Ⅱ gastrectomy was completed in all of the 7 patients by open surgery(3) or laparoscopy(4).No serious intra- and post-operative complications occurred in the series.The preoperative level of fasting plasma glucose(FPG) was between 6.6 and 9.0 mmol/L(mean 8.1 mmol/L) and glycosylated hemoglobin concentrations(HbA1c) between 6.8% and 9.5%(mean 7.8%).While 1 to 8 months after the surgery,the FPG decreased to 4.8-7.9 mmol/L(mean 6.4 mmol/L) and HbA1c 5.5% to 7.2%(mean 6.3%).According to the criteria from ADA,4 patients were cured and 3 were improved.Conclusion Billroth Ⅱ gastrectomy is effective for type 2 diabetes mellitus in patients with gastric cancer.