• <tr id="yyy80"></tr>
  • <sup id="yyy80"></sup>
  • <tfoot id="yyy80"><noscript id="yyy80"></noscript></tfoot>
  • 99热精品在线国产_美女午夜性视频免费_国产精品国产高清国产av_av欧美777_自拍偷自拍亚洲精品老妇_亚洲熟女精品中文字幕_www日本黄色视频网_国产精品野战在线观看 ?

    Endoscopic approach for the treatment of bariatric surgery complications

    2020-08-01 07:20:06
    Mini-invasive Surgery 2020年3期

    Division of Bariatric,Foregut and Advanced Gastrointestinal Surgery,Department of Surgery,Stony Brook University Medical Center,Stony Brook,New York,NY 11794-8191,USA.

    Abstract

    Keywords:Bariatric surgery,advanced endoscopy,intraluminal surgery

    INTRODUCTION

    Obesity is a public health problem[1].The number of bariatric procedures performed in the United States has increased significantly in the past decades[1,2].Laparoscopic Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (LSG) are the most common bariatric procedures performed[2,3].The overall mortality rate of bariatric surgery is < 0.2%,yet the morbidity rate is between 4% and 10% with complications presenting most commonly within the first 30 days after surgery[2-4].Some of the postoperative complications may be managed intraluminally using advances in surgical and interventional endoscopy[2-6].

    Complications can be divided into early (< 30 days) or late (> 30 days)[3,7].Some can be encountered after any bariatric procedure and others are procedure specific[3].The cornerstone for the diagnosis of luminal complications after weight loss surgery is esophagogastroduodenoscopy (EGD).Diagnostic and therapeutic EGD should not be delayed for fear of disruption of a fresh anastomosis.Evidence has shown it is safe and cost-effective to perform upper endoscopy in the early postoperative period[8].

    BLEEDING

    Acute or early gastrointestinal (GI) hemorrhage usually presents within the first hours to days after surgery and it is often secondary to technical error[2,3].Its incidence is 1%-4%[9].Although bleeding usually occurs from the submucosal vessels along the staple line at the gastrojejunostomy,jejunojejunostomy,or the sleeve staple line,it can occur anywhere along the GI tract.Possible sites of bleeding include the gastric pouch and the gastric remnant,as well as extraluminal,at trocar insertion sites,dissection planes,or mesenteric or omental transection areas[2-4].Late bleeding is usually caused by marginal ulceration or erosion (discussed below)[5,9].

    Signs and symptoms of early postoperative bleeding include tachycardia,hemoglobin level drop,hematemesis,or hematochezia[9].Hemodynamically stable patients are initially treated non-operatively with fluid resuscitation,close monitoring,proton pump inhibitors (PPIs),and blood transfusion as needed[2-4,6,9].For patients who present hemodynamically unstable,further operative or endoscopic procedures are warranted[2-4].

    Different endoscopic treatments are available to manage a bleed: injection of diluted epinephrine or sclerosing agents,application of hemoclips or larger bear claw clips (Over-the-scope-clip,OTSC,Ovesco),thermal therapies (heater probe,mono- and bipolar electrocoagulation,argon plasma coagulation,and laser therapy),and application of hemostatic powder,fibrin,or thrombin glues[2-6].Standard endoscopes can reach proximal bleeders in the gastric pouch or the sleeve staple line.For distal bleeders,balloon- or spiral-assisted enteroscopy,or even surgical assistance,may be needed to reach the jejunojejunostomy or the gastric remnant[2,3].

    LEAKS AND FISTULAS

    Leaks commonly occur at the anastomosis or staple line[2].After RYGB,leaks are usually seen at the gastrojejunal (GJ) anastomosis,in up to 2%-5% of cases[2,5]but can occur at any staple line or other location on the GI tract.After LSG,leaks are most common near the angle of His,where the staple line meets the gastroesophageal junction[2,3].This is attributed to distal stenosis,increased proximal pressure,thinner tissue,and relative vascular watershed on angiographic studies,and occurs in 1%-9% of cases[2,4].After duodenal switch,leaks may also be seen at the duodenojejunal (DJ) anastomosis.

    Leaks are associated with significant morbidity and mortality.Although rare,with an incidence of 1%-6%,several factors are believed to contribute in their development[2-4].Ischemia,technical error such as overlapping staple lines,or anastomotic tension are suspected among the factors that leads to leaks[2].Fistulas are defined as an abnormal communication between the GI tract and another organ (in the abdomen or thorax) or surface[7,10].Generally,fistulas are related to acute leaks that fail to close in more than 12 weeks[7].Complications after RYGB are gastrogastric fistulas between the gastric pouch and remnant,fistulas to the surrounding viscous organs,or fistulas to the skin[10].

    Figure1.Leakage Endo-Sponge treatment[6].A: evidence of fistula; B: placement of Endo-Sponge treatment

    Signs and symptoms of leaks include abdominal pain,fevers,and tachycardia[2].Suspicion of a leak requires thorough work up to assess the location and size of the defect,infection control with antibiotics,nutritional optimization,and appropriate therapeutic intervention[2,4].A CT scan is usually required to assess for intraabdominal fluid collections.If there is any surrounding fluid collection distant to the GI lumen,this needs to be drained by interventional radiology,laparoscopically,or transluminal endoscopic debridement and drainage (by endo-vacuum or with pigtail catheters) [Figure1][2-5,7].Depending on the size of the fistula,different approaches can be taken.The key goals of endoscopic treatment are to cover (self-expandable metallic stents,SEMS) or close the fistula (de-epithelialization,clips,endoscopic suturing (Overstitch),and secondary intention with aid of a vacuum or septotomy)[7].Small fistulas can be closed with OTSC[2,4,5].Larger defects can be covered with stents or closed with sutures[2,4,5,7],although surgical intervention may be required [Figure2].

    SEMS are the most commonly used endoscopic modality for leak treatment[2-6].The self-expandable stents are placed over the leak area,isolating the area from the esophageal and gastric secretions,preventing further contamination and enhancing healing[2,6,7].Patients can resume oral intake while the stent is in place,which enhances their nutrition and further healing.Stent placement is done under fluoroscopy and stents are later removed in 2-3 weeks to assess healing rate and prevent stent incorporation into the native tissue[2-4].Stent migration,described in > 40% of cases,is a possible complication with the usage of stents.Migration might require urgent endoscopy with stent removal and possible replacement.Modalities such as clips to minimize migration have been employed with some success.Endoscopic suturing,OTSCs,and glue injection have been used as adjuncts to stenting[2-4].Systematic reviews and meta-analysis have been done to show the success of stenting,with a pooled proportion of successful leak closures of 87.77%[11].

    BEZOARS

    Bezoars consist of coagulated blood,undigestable fibers,undigested milk products,hair,or medications found intraluminally that do not pass through the GI tract[2].Bezoars can be found following bariatric surgery and may lead to bowel obstruction.The incidence of bezoar-induced obstruction is unknown since the literature consists of mostly case reports.A stricture in the GJ anastomosis or foreign bodies at the staple line can serve as a nidus for bezoar formation.Endoscopy is used for diagnosis and treatment[2,4].Techniques used to break the bezoar include water jet fragmentation,direct suction,and drills[2,5,6].

    FAILURE TO THRIVE

    Placement of a nasogastric or nasojejunal feeding tubes can be done with endoscopy[6].Patients who develop complications such as fistula or leak that need to be keptnil per oscan maintain their calorie intake through enteral feeds.Placing the tube with endoscopic guidance prevents further tissue damage[4,6].

    STRICTURE AND STENOSIS

    Stricture and stenosis peaks 3-4 weeks postoperatively and presents with dysphagia to solid food that progresses to intolerance to liquids[2,4].Other symptoms include nausea,emesis,reflux,and epigastric pain[7].

    Figure2.Gastrogastric fistula (B) after endoscopic repair[5].A: evidence of gastrogastric fistula; B: after endoscopic repair

    After RYGB,GJ anastomotic stricture is the most common site of primary strictures[7].This is defined as a stoma that is < 10 mm in diameter.Stricture incidence is 3%-28%[2,7].Causes are multifactorial,including chemical agents [nonsteroidal anti-inflammatory drugs (NSAIDs) and tobacco],surgical technique (circularvs.linear staplervs.hand sewn anastomosis),anastomotic tension and suture granuloma,among others[7].The stricture can be classified by its endoscopic appearance into mild (allowing passage of a 10.5-mm endoscope),moderate (allowing passage of an 8.5-mm pediatric endoscope),severe (allowing passage of a guidewire),or complete/near-complete obstruction (no passage of any instrumentation)[12].

    After LSG,stenosis can occur at the incisura angularis or gastroesophageal junction[7].Sleeve stenosis occurs in between 0.1% and 3.9% of cases[2].The causes are not clearly defined,but some reasons narrowing occurs are due to partial or complete over-sewing of the staple line or improper placement of the staple line (relative to the incisura or causing a torsion along its axis)[7].Bougie size has not been found to be a factor contributing to strictures[7].

    Treatment consists of repetitive through the scope balloon dilation or bougienage in 10-14-day intervals[5,6][Figure3].One to two dilations to 18 mm are usually enough to achieve permanent patency of the anastomosis.If the stenosis is too narrow for the scope to pass,a guidewire is used for the balloon and bougie dilation under fluoroscopy[2,4,7].These techniques give the endoscopist the ability to assess the resistance of the stenosis and decide if a larger balloonvs.bougie can be advanced.Strictures dilated within the first three months are more likely to be resolved with endoscopic dilation and less likely to require revisional surgery[7].The GJ anastomotic size should not exceed 15 mm; otherwise,the patient is at risk of weight regain[2-6].Resistant strictures can be managed with endoscopic stricturoplasty and/or steroid injection.For Kenalog injection,1 mg of steroid is divided into four injections in the periphery of the stricture[13].

    A new endoscopic technique has been described for the treatment of strictures.A tunneled stricturotomy can be performed in experienced hands with good results in several case reports.Further studies are needed for long-term results[14].

    MARGINAL ULCERS

    Ulceration is a late complication.Marginal ulcers are found on the jejunal side of the gastrojejunostomy in the RYGB patients[2].Stomal ulcers are those that occur on the gastric side of the anastomosis and are believed to be caused by local ischemia.Marginal ulcer incidence is 2%-18%[2,4,15].They are usually seen a few weeks or years after surgery.Risk factors for their development are poorly understood,but include poor blood supply to the anastomosis; presence of a foreign material (sutures or staples); use of NSAIDs,steroids,tobacco,or alcohol; chemical inflammation due to gastric secretions; andHelicobacter pyloriinfection[2-6].

    Figure3.Anastomotic stenosis,before and after balloon dilation[6].A: anastomotic stenosis; B: balloon dilation; C: anatomosis after dilation

    Prevention of marginal ulcers has been the focus of multiple bariatric publications.Avoiding NSAIDs,smoking cessation,and prophylactic PPIs have been the most widely used standard practices to reduce the incidence of marginal ulcers[2,3].Treatment includes PPIs,sucralfate solution,and misoprostol (in patients who have been taking NSAIDs)[2,4,5,7].

    EGD has been used to aid in the diagnosis and to elucidate the etiology of the ulcers.If a foreign body is identified,it should be removed to facilitate healing[5].These can be achieved by using over the scope grasping forceps,rat-tooth forceps,or standard endoscopic scissors[2].Repeat EGD should be performed to confirm healing of marginal ulcers.Non-healing or recurrent ulcers should prompt investigation of underlying problems such as gastrogastric fistula as the cause of the ulcer[5,6].Ulcers that persist despite medical therapy should be considered for surgical management.

    WEIGHT REGAIN

    Inadequate weight loss or failure to respond to bariatric surgery is multifactorial and must be addressed with a multidisciplinary approach.Different factors have been identified: medical (anatomic factors,nutritional deficiencies,and metabolic parameters),psychological (emotional ties to cravings and food addiction),or educational (dietitian counseling,preoperative weight loss goals,calorie counting,and noncompliance to follow up)[7].

    A dilated GJ anastomosis has been associated with weight regain.This is often identified within the first two years after surgery[7].Multiple endoscopic techniques have been described with limited success[2,7,16].

    Endoscopic narrowing of the anastomosis can be facilitated with a variety of techniques.Some techniques,such as injection of sclerosing agents,have been abandoned due to limited success or complications[2-4,16].Using the OTSC or the Overstitch device are newer techniques that can be used over the scope to reduce the stoma size[16,17].Long-term published outcomes from these techniques are limited[2-6,17].

    BILIARY DISEASE

    Figure4.Band erosion[5]

    Choledocholithiasis is frequently encountered in bariatric surgery patients,both preoperatively and postoperatively[2].Common bile duct stones extraction after LSG is usually achievable using a standard approach; in contrast,getting access to the papilla in patients with RYGB anatomy is difficult[2-4].In skillful endoscopist hands,an endoscopic retrograde cholangiopancreatography (ERCP) is successful 60% of the time in these patients[2-4].The most common route used is to laparoscopically get access to the gastric remnant and through there get access to the papilla.An alternative is to use endoscopic ultrasound to create a gastrogastric fistula with SEMS placement,through which the scope can enable access to the papilla and subsequent ERCP[2,6].Closure of the resultant gastrogastric fistula following this procedure is not well studied.

    BAND EROSION

    Even though laparoscopic gastric banding has decreased in popularity due to its long-term complications and lack of sustained weight loss,its complications are still relatively common presentations in bariatric centers.

    Transmural migration of the band through the gastric wall occurs in 7% of gastric banding patients[2].Endoscopy plays a role in the diagnosis and treatment of this complication.Endoscopic removal of eroded bands has been described[2-4].With the use of ultrasonic shears,or preferably placing a wire around the band and using an ERCP rescue device,the band and tubing complex can be cut and removed transorally[18][Figure4].Endoscopic removal is most likely to be successful if the band buckle is within the gastric lumen.Traditionally,removal of the band is performed with a combination of laparoscopy and endoscopy[2,18].

    GASTROESOPHAGEAL REFLUX DISEASE

    As the rate of sleeve gastrectomy procedures performed in the US increases,the rate ofde novogastroesophageal reflux disease (GERD) after surgery and new-onset Barrett's esophagus has increased[4,5].The use of novel endoscopic techniques to address GERD after bariatric surgery has slowly gained popularity.Several case reports have been published with successful results.The use of radiofrequency energy (Stretta) is the most widely described.The antireflux mucosectomy procedure involves endoscopic mucosal resection of the gastroesophagic junction and is also described[10,19].The healing of the mucosal defect stimulates scar formation that improves reflux[19].Further studies are needed to evaluate the longterm success of this approach.

    SUMMARY

    As the incidence of obesity increases exponentially,so does the incidence of bariatric surgery performed in the US.Complications of these procedures can present days to years postoperatively.Many of these complications can be managed endoscopically.Advances in endoscopic techniques have facilitated a minimally invasive approach with successful results.Upper endoscopy has been shown to be safe and cost effective in the diagnosis and treatment of bariatric surgery complications in the early and late postoperative period.

    DECLARATIONS

    Authors' contributions

    Contributed to the design of the research,drafting of the manuscript and critical revision: Ardila-Gatas J,Pryor A

    Availability of data and materials

    Not applicable.

    Financial support and sponsorship

    None.

    Conflicts of interest

    All authors declared that there are no conflicts of interest.

    Ethical approval and consent to participate

    Not applicable.

    Consent for publication

    Not applicable.

    Copyright

    ? The Author(s) 2020.

    久久精品国产自在天天线| 久久久久视频综合| 人人妻人人澡人人爽人人夜夜| 国产不卡av网站在线观看| 成人亚洲精品一区在线观看| 国产色婷婷99| 999久久久国产精品视频| 久久久久久人妻| 纯流量卡能插随身wifi吗| 五月伊人婷婷丁香| 女人高潮潮喷娇喘18禁视频| 亚洲国产日韩一区二区| 国产欧美日韩综合在线一区二区| 久久综合国产亚洲精品| 欧美成人精品欧美一级黄| 国产不卡av网站在线观看| 欧美激情极品国产一区二区三区| 99久国产av精品国产电影| 婷婷色麻豆天堂久久| 中文字幕人妻丝袜制服| 岛国毛片在线播放| 国产成人精品福利久久| 人人妻人人澡人人爽人人夜夜| 久久鲁丝午夜福利片| 老司机影院毛片| 免费观看av网站的网址| 菩萨蛮人人尽说江南好唐韦庄| 亚洲精品av麻豆狂野| 热re99久久精品国产66热6| 两个人免费观看高清视频| 免费观看av网站的网址| 多毛熟女@视频| 男人爽女人下面视频在线观看| 波多野结衣av一区二区av| 欧美日韩综合久久久久久| 搡女人真爽免费视频火全软件| xxxhd国产人妻xxx| 999精品在线视频| 尾随美女入室| 中文字幕人妻熟女乱码| 嫩草影院入口| 女的被弄到高潮叫床怎么办| 色94色欧美一区二区| 最黄视频免费看| 日本av手机在线免费观看| 青春草国产在线视频| 少妇被粗大的猛进出69影院| 亚洲精品久久久久久婷婷小说| 亚洲欧洲精品一区二区精品久久久 | av在线老鸭窝| 亚洲av电影在线进入| 少妇被粗大猛烈的视频| 国产成人免费无遮挡视频| 国产成人欧美| 美女高潮到喷水免费观看| 中文字幕人妻熟女乱码| 国产成人免费无遮挡视频| 熟妇人妻不卡中文字幕| 成年女人在线观看亚洲视频| 国产成人精品福利久久| 久久人妻熟女aⅴ| 亚洲一区二区三区欧美精品| 婷婷色麻豆天堂久久| 91aial.com中文字幕在线观看| 中文字幕人妻丝袜一区二区 | 大片免费播放器 马上看| 卡戴珊不雅视频在线播放| 中文字幕精品免费在线观看视频| 久久久久久久久久久久大奶| 国产无遮挡羞羞视频在线观看| 久久久国产欧美日韩av| 久久国产精品大桥未久av| av免费观看日本| 精品第一国产精品| 国产 精品1| 999久久久国产精品视频| 亚洲精品国产av蜜桃| 日韩三级伦理在线观看| 自拍欧美九色日韩亚洲蝌蚪91| 七月丁香在线播放| 啦啦啦在线观看免费高清www| 人人妻人人添人人爽欧美一区卜| 久久国内精品自在自线图片| 看十八女毛片水多多多| 天天影视国产精品| 欧美激情高清一区二区三区 | 一级片'在线观看视频| 99久久精品国产国产毛片| 国产精品麻豆人妻色哟哟久久| 欧美xxⅹ黑人| 人人澡人人妻人| 蜜桃国产av成人99| 一本一本久久a久久精品综合妖精 国产伦在线观看视频一区 | 国产亚洲最大av| 国产精品免费视频内射| 十八禁网站网址无遮挡| 91国产中文字幕| 亚洲av.av天堂| 熟女少妇亚洲综合色aaa.| 色视频在线一区二区三区| 久久精品久久精品一区二区三区| 啦啦啦在线免费观看视频4| 国产免费视频播放在线视频| 午夜福利视频精品| 国产精品99久久99久久久不卡 | 亚洲欧美中文字幕日韩二区| 飞空精品影院首页| 日本欧美视频一区| 伦理电影大哥的女人| 日韩av在线免费看完整版不卡| 精品国产乱码久久久久久小说| 各种免费的搞黄视频| 日本wwww免费看| 国产一区亚洲一区在线观看| 亚洲国产精品一区三区| 婷婷色综合www| 中文字幕制服av| 国产午夜精品一二区理论片| 免费女性裸体啪啪无遮挡网站| av免费观看日本| 中文字幕av电影在线播放| 韩国av在线不卡| 天天操日日干夜夜撸| 亚洲少妇的诱惑av| 午夜影院在线不卡| 18禁动态无遮挡网站| 涩涩av久久男人的天堂| 一个人免费看片子| 高清视频免费观看一区二区| 久久99一区二区三区| 又大又黄又爽视频免费| 国产人伦9x9x在线观看 | 叶爱在线成人免费视频播放| 可以免费在线观看a视频的电影网站 | 秋霞在线观看毛片| 国产白丝娇喘喷水9色精品| 成人国产av品久久久| 国产爽快片一区二区三区| 国产男女超爽视频在线观看| av又黄又爽大尺度在线免费看| 午夜激情av网站| 免费在线观看完整版高清| 波多野结衣一区麻豆| 大片免费播放器 马上看| 免费少妇av软件| 日韩av不卡免费在线播放| 人人澡人人妻人| 丝瓜视频免费看黄片| 免费观看在线日韩| 国产综合精华液| 久久精品国产鲁丝片午夜精品| 高清黄色对白视频在线免费看| 久久午夜综合久久蜜桃| 97在线人人人人妻| 国产黄频视频在线观看| 最近手机中文字幕大全| 国产在线视频一区二区| 午夜激情久久久久久久| 狠狠精品人妻久久久久久综合| 丰满饥渴人妻一区二区三| 久久久久久久大尺度免费视频| av线在线观看网站| 国产成人午夜福利电影在线观看| av有码第一页| 国产女主播在线喷水免费视频网站| 成人毛片60女人毛片免费| 观看av在线不卡| 2018国产大陆天天弄谢| 国产精品久久久久成人av| 老汉色∧v一级毛片| av线在线观看网站| 成人午夜精彩视频在线观看| 国产成人精品无人区| 国产欧美日韩综合在线一区二区| 美女xxoo啪啪120秒动态图| 精品一区二区三卡| 丝袜人妻中文字幕| 性色avwww在线观看| 成人午夜精彩视频在线观看| 国产成人免费观看mmmm| 亚洲欧美日韩另类电影网站| 丝袜美腿诱惑在线| 久久影院123| 精品亚洲乱码少妇综合久久| 国产精品成人在线| av女优亚洲男人天堂| 国产在线视频一区二区| 亚洲国产欧美在线一区| 久久精品久久久久久久性| 亚洲成人av在线免费| 丰满乱子伦码专区| av在线老鸭窝| 精品国产乱码久久久久久小说| 国产精品嫩草影院av在线观看| 亚洲男人天堂网一区| 美女国产视频在线观看| 久久久久久免费高清国产稀缺| 国产有黄有色有爽视频| 日本爱情动作片www.在线观看| 日本91视频免费播放| 18在线观看网站| 亚洲婷婷狠狠爱综合网| 熟女av电影| 亚洲伊人久久精品综合| 999精品在线视频| 亚洲欧美精品自产自拍| 91精品国产国语对白视频| 国产精品香港三级国产av潘金莲 | 国产成人精品在线电影| 中国国产av一级| 高清在线视频一区二区三区| 大香蕉久久成人网| 在线 av 中文字幕| 午夜福利在线免费观看网站| 9色porny在线观看| 亚洲国产毛片av蜜桃av| 亚洲欧美成人综合另类久久久| 久久久久精品性色| 大陆偷拍与自拍| 制服人妻中文乱码| 一区福利在线观看| 亚洲精品乱久久久久久| 女人被躁到高潮嗷嗷叫费观| 欧美日韩成人在线一区二区| av女优亚洲男人天堂| 成人免费观看视频高清| 黄片播放在线免费| 精品人妻在线不人妻| 亚洲美女视频黄频| 9热在线视频观看99| 久久av网站| 69精品国产乱码久久久| 国产综合精华液| 免费看av在线观看网站| 1024香蕉在线观看| 国产黄色免费在线视频| 18禁裸乳无遮挡动漫免费视频| 国产片内射在线| 一级毛片我不卡| 美女午夜性视频免费| 欧美xxⅹ黑人| 最近最新中文字幕免费大全7| 人妻 亚洲 视频| 99久久精品国产国产毛片| 国产欧美日韩一区二区三区在线| 久久鲁丝午夜福利片| 免费播放大片免费观看视频在线观看| 日本爱情动作片www.在线观看| 久热久热在线精品观看| 国产又色又爽无遮挡免| 永久免费av网站大全| 午夜激情久久久久久久| 欧美日韩av久久| 巨乳人妻的诱惑在线观看| 人体艺术视频欧美日本| 大码成人一级视频| 美女国产高潮福利片在线看| 欧美变态另类bdsm刘玥| 午夜av观看不卡| 嫩草影院入口| 日本欧美视频一区| 丝袜人妻中文字幕| 青春草亚洲视频在线观看| 男的添女的下面高潮视频| 最黄视频免费看| 男男h啪啪无遮挡| av在线老鸭窝| 亚洲成色77777| 国产成人欧美| 国产欧美日韩一区二区三区在线| 黄片小视频在线播放| 大香蕉久久成人网| 亚洲精品久久午夜乱码| 天天影视国产精品| 国产精品一国产av| 女性被躁到高潮视频| 亚洲精品一二三| 亚洲精品久久久久久婷婷小说| 啦啦啦中文免费视频观看日本| 亚洲av在线观看美女高潮| 国产免费现黄频在线看| 欧美日韩精品成人综合77777| 97在线视频观看| 两性夫妻黄色片| 男女边吃奶边做爰视频| 亚洲四区av| a级片在线免费高清观看视频| 亚洲精品自拍成人| 久久久精品国产亚洲av高清涩受| 丝袜美足系列| 另类精品久久| 老汉色av国产亚洲站长工具| 亚洲一级一片aⅴ在线观看| 在线观看人妻少妇| a级片在线免费高清观看视频| 啦啦啦在线观看免费高清www| 国产有黄有色有爽视频| 两个人看的免费小视频| 久久99热这里只频精品6学生| 男女午夜视频在线观看| 纵有疾风起免费观看全集完整版| 国产人伦9x9x在线观看 | 国产欧美亚洲国产| 欧美精品一区二区免费开放| 国产男女内射视频| 亚洲av综合色区一区| 亚洲av电影在线进入| 最近最新中文字幕免费大全7| 黑丝袜美女国产一区| www.精华液| 国产成人免费无遮挡视频| 国产深夜福利视频在线观看| 交换朋友夫妻互换小说| 国产日韩一区二区三区精品不卡| 亚洲精品中文字幕在线视频| 国产精品二区激情视频| 波多野结衣一区麻豆| 美国免费a级毛片| 国产精品国产av在线观看| 欧美精品一区二区免费开放| 免费观看性生交大片5| 国产乱人偷精品视频| 欧美最新免费一区二区三区| 日本vs欧美在线观看视频| 欧美精品亚洲一区二区| 亚洲精品美女久久av网站| 亚洲综合色惰| 五月天丁香电影| 国产探花极品一区二区| 国产精品成人在线| 欧美日韩综合久久久久久| 亚洲综合色惰| 在线免费观看不下载黄p国产| 国产av精品麻豆| 天天躁日日躁夜夜躁夜夜| a级毛片黄视频| 国产伦理片在线播放av一区| 中国三级夫妇交换| 亚洲一区中文字幕在线| 亚洲精品一二三| 视频区图区小说| 黄色视频在线播放观看不卡| 成人漫画全彩无遮挡| 亚洲欧美中文字幕日韩二区| 国产成人一区二区在线| 精品国产乱码久久久久久小说| 久久久精品94久久精品| 久久午夜综合久久蜜桃| 男人舔女人的私密视频| 精品国产露脸久久av麻豆| www.熟女人妻精品国产| 天天躁夜夜躁狠狠躁躁| a级毛片在线看网站| 国产成人a∨麻豆精品| 男女边吃奶边做爰视频| 桃花免费在线播放| 在线观看www视频免费| 欧美精品人与动牲交sv欧美| 精品少妇内射三级| 国产色婷婷99| 哪个播放器可以免费观看大片| 国产片特级美女逼逼视频| 久久久国产精品麻豆| 国产高清国产精品国产三级| 国产精品久久久av美女十八| 少妇人妻久久综合中文| 热re99久久精品国产66热6| 人成视频在线观看免费观看| 热re99久久国产66热| 永久网站在线| 青青草视频在线视频观看| videos熟女内射| 国产黄频视频在线观看| 咕卡用的链子| 国产精品香港三级国产av潘金莲 | 精品国产乱码久久久久久男人| 久久精品国产综合久久久| 久久女婷五月综合色啪小说| 亚洲av综合色区一区| 久久人人97超碰香蕉20202| 亚洲色图 男人天堂 中文字幕| 在线观看www视频免费| 两性夫妻黄色片| 另类精品久久| 国产欧美日韩综合在线一区二区| 亚洲图色成人| 成人国产av品久久久| 日韩大片免费观看网站| 黄网站色视频无遮挡免费观看| 免费大片黄手机在线观看| 欧美另类一区| 亚洲国产毛片av蜜桃av| 一区在线观看完整版| 一区二区三区乱码不卡18| 亚洲欧美成人精品一区二区| 最新中文字幕久久久久| 五月天丁香电影| www.av在线官网国产| 高清av免费在线| 秋霞在线观看毛片| 黄频高清免费视频| 国精品久久久久久国模美| 久久这里有精品视频免费| 精品一区二区三区四区五区乱码 | 成人毛片60女人毛片免费| 免费在线观看视频国产中文字幕亚洲 | 国产亚洲最大av| 国产一区有黄有色的免费视频| 婷婷色综合大香蕉| 男人舔女人的私密视频| 亚洲成人一二三区av| 美女午夜性视频免费| 只有这里有精品99| 美国免费a级毛片| 精品酒店卫生间| 高清av免费在线| 伊人久久国产一区二区| 日韩人妻精品一区2区三区| 午夜福利视频精品| 亚洲,欧美精品.| 亚洲内射少妇av| 亚洲伊人色综图| 亚洲天堂av无毛| 777久久人妻少妇嫩草av网站| 丝袜美腿诱惑在线| 久久韩国三级中文字幕| 午夜福利,免费看| 多毛熟女@视频| 久久亚洲国产成人精品v| 最近中文字幕高清免费大全6| 国产一区二区三区综合在线观看| 9191精品国产免费久久| 永久网站在线| 欧美成人午夜精品| 国产欧美日韩综合在线一区二区| 天天躁狠狠躁夜夜躁狠狠躁| 欧美国产精品一级二级三级| 十八禁网站网址无遮挡| 精品卡一卡二卡四卡免费| 精品国产乱码久久久久久男人| 美女国产高潮福利片在线看| 成人手机av| 午夜精品国产一区二区电影| 国产精品亚洲av一区麻豆 | 亚洲三级黄色毛片| 成人国产av品久久久| 亚洲av电影在线进入| 1024香蕉在线观看| 久久久久精品久久久久真实原创| 777久久人妻少妇嫩草av网站| 在线精品无人区一区二区三| 精品久久蜜臀av无| 亚洲国产成人一精品久久久| 边亲边吃奶的免费视频| 久久午夜综合久久蜜桃| 国产淫语在线视频| 大码成人一级视频| 九九爱精品视频在线观看| 日韩不卡一区二区三区视频在线| 天天躁狠狠躁夜夜躁狠狠躁| 欧美精品av麻豆av| 十八禁网站网址无遮挡| 亚洲国产精品一区三区| 午夜福利乱码中文字幕| 国产97色在线日韩免费| 久久久久久久国产电影| 中文欧美无线码| 少妇人妻精品综合一区二区| 亚洲欧美精品自产自拍| 9191精品国产免费久久| videosex国产| 国产成人av激情在线播放| 另类亚洲欧美激情| 熟女少妇亚洲综合色aaa.| 免费黄频网站在线观看国产| 精品国产一区二区久久| 中文字幕制服av| 成人黄色视频免费在线看| 青春草国产在线视频| 国产黄色免费在线视频| 精品99又大又爽又粗少妇毛片| av免费在线看不卡| 久久毛片免费看一区二区三区| 亚洲 欧美一区二区三区| 精品国产乱码久久久久久男人| 亚洲欧美一区二区三区国产| 亚洲熟女精品中文字幕| 久久精品国产鲁丝片午夜精品| 国产精品免费大片| 精品少妇黑人巨大在线播放| 中文字幕精品免费在线观看视频| 日产精品乱码卡一卡2卡三| 国产一级毛片在线| 久久久久视频综合| 国产成人一区二区在线| 一本久久精品| 欧美亚洲 丝袜 人妻 在线| 久久久久久久国产电影| 欧美日韩亚洲国产一区二区在线观看 | 美女国产视频在线观看| 亚洲人成网站在线观看播放| 热re99久久国产66热| 交换朋友夫妻互换小说| 久久久久久人人人人人| 大码成人一级视频| 十八禁网站网址无遮挡| 99久国产av精品国产电影| 一区二区三区精品91| 国产乱人偷精品视频| www.熟女人妻精品国产| 色94色欧美一区二区| 国产 精品1| 日韩中字成人| 日韩精品免费视频一区二区三区| 国产av国产精品国产| 色网站视频免费| 亚洲欧美日韩另类电影网站| 国产精品秋霞免费鲁丝片| 成人午夜精彩视频在线观看| 美女福利国产在线| 男女边摸边吃奶| 999久久久国产精品视频| 高清av免费在线| 亚洲国产日韩一区二区| av女优亚洲男人天堂| 中文字幕人妻熟女乱码| 国产色婷婷99| 久久97久久精品| 亚洲一码二码三码区别大吗| 久久久久久久大尺度免费视频| 国产成人精品婷婷| 黄色配什么色好看| 在线亚洲精品国产二区图片欧美| 欧美亚洲 丝袜 人妻 在线| 国产深夜福利视频在线观看| 精品一区在线观看国产| 大陆偷拍与自拍| 日韩一区二区三区影片| 成人国产av品久久久| 成人亚洲欧美一区二区av| 亚洲精品第二区| 亚洲综合色惰| 欧美黄色片欧美黄色片| 国产精品久久久久成人av| 如日韩欧美国产精品一区二区三区| 老女人水多毛片| 青青草视频在线视频观看| 午夜福利在线观看免费完整高清在| 亚洲av综合色区一区| xxx大片免费视频| 日本黄色日本黄色录像| 丝袜脚勾引网站| 亚洲欧美成人综合另类久久久| 80岁老熟妇乱子伦牲交| 99久久综合免费| 日韩av在线免费看完整版不卡| 久久精品国产亚洲av天美| av一本久久久久| 人体艺术视频欧美日本| 国产无遮挡羞羞视频在线观看| 精品国产乱码久久久久久小说| 国产日韩欧美亚洲二区| 亚洲精品乱久久久久久| 久久国产精品男人的天堂亚洲| 久久久久视频综合| 久久精品aⅴ一区二区三区四区 | 青春草国产在线视频| 国产熟女午夜一区二区三区| 欧美亚洲日本最大视频资源| 中文字幕人妻熟女乱码| 免费黄网站久久成人精品| 久久久精品国产亚洲av高清涩受| 久久久久久人妻| 日韩一卡2卡3卡4卡2021年| 精品亚洲成国产av| xxx大片免费视频| 国产午夜精品一二区理论片| 亚洲av男天堂| 亚洲三级黄色毛片| 制服人妻中文乱码| 亚洲中文av在线| 美国免费a级毛片| 日韩av在线免费看完整版不卡| 国产成人欧美| 一级毛片 在线播放| 久久久精品免费免费高清| 国产成人av激情在线播放| 岛国毛片在线播放| 99九九在线精品视频| 免费观看av网站的网址| 女人被躁到高潮嗷嗷叫费观| 一级毛片电影观看| 中文字幕另类日韩欧美亚洲嫩草| 超碰97精品在线观看| 一边亲一边摸免费视频| 免费高清在线观看日韩| 国产无遮挡羞羞视频在线观看| 高清av免费在线| 国产男女超爽视频在线观看| 妹子高潮喷水视频| 久久久国产一区二区| 国产男女超爽视频在线观看| 婷婷色av中文字幕| www.精华液| 熟女电影av网| 中文字幕制服av| 在线观看国产h片| 国产成人精品无人区| 久久精品国产鲁丝片午夜精品| 观看美女的网站| 亚洲av欧美aⅴ国产| 日日啪夜夜爽| 观看美女的网站| 亚洲激情五月婷婷啪啪| 亚洲欧美色中文字幕在线|