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논문KCI 등재

소장의 치료 내시경

Therapeutic Small Bowel Endoscopy in Practice

장현주
대한소화기내시경학회 (The Korean Society Of Gastrointestinal Endoscopy)|2009.08|Clinical Endoscopy|제39권 제2호|pp. 59-65

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참고문헌

키워드

치료Therapy소장Endoscopy내시경Small intestine
주제분류내과학

초록

DBE는 전 소장을 관찰할 뿐만 아니라, 조직 생검을 비롯한 다양한 치료 내시경 시술이 가능하여 단 시간 내에 소장 질환의 진단과 치료에 많은 변화를 가져왔다. 소장의 치료 내시경 시술 분야에서 초기의 진단용 DBE는 지혈술, 용종 절제술 등 몇 가지 술기만 가능하였으나, 겸자공이 큰 치료용 DBE가 개발되면서 위 또는 대장내시경에서 적용하는 대부분의 치료내시경 시술을 할 수 있다. 하지만 소장의 치료 내시경 시술은 장시간의 시술시간과 시술자의 물리적인 노력이 많이 필요하며, 치료내시경 시술의 장기 치료 성적에 대한 연구가 부족하다. 본 종설은 소장의 치료내시경 시술 경험을 바탕으로 문헌고찰과 함께, 소장의 치료내시경 시술들과 주의할 점을 살펴서 정리하였다.

Abstract

Since the first introduction of double balloon enteroscopy (DBE) in 2001, DBE has been refined for complete exploration of the small bowel and therapeutic interventions. Diagnostic DBE using a model EN-450P5 (Fujinon, Saitama, Japan) equipped with a small accessory channel is mainly used for endoscopic observation and limited therapeutic procedures including injection therapy, argon plasma coagulation and polypectomy. Therapeutic DBE utilizing a model EN-450T5 (Fujinon, Saitama, Japan) equipped with a larger accessory channel was developed for various endoscopic interventions. Recently, new enteroscopic techniques such as single balloon enteroscopy and spiral enteroscopy were introduced. These enteroscopic techniques are all used for the controlled observation, targeted tissue sampling for pathologic evaluation and various therapeutic interventions. The overall complication rate of DBE seems acceptable but that of therapeutic DBE is higher than diagnostic DBE and therapeutic colonoscopies because the small intestinal wall is much thinner than other intestinal wall. This review provides an overview concerning therapeutic interventions of DBE.

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