A Case Series: Outcomes of Endoscopic Biliary Self-Expandable Metal Stent for Malignant Biliary Obstruction with Surgically Altered Anatomy

Yamauchi, Hiroshi; Kida, Mitsuhiro; Okuwaki, Kosuke; Miyazawa, Shiro; Iwai, Tomohisa; Inoue, Hiroshi; Miyata, Eiji; Hasegawa, Rikiya; Koizumi, Wasaburo

doi:10.1007/s10620-016-4148-8

Cited by 17 publications

(18 citation statements)

References 24 publications

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“…Endoscopic treatment of malignant biliary obstruction in patients with surgically altered anatomy is much more difficult. Yamauchi et al [50] reported a 100% technical success rate and 92% functional success rate with placement of an 8.5-Fr uncovered self-expandable metal stent (SEMS) for malignant biliary obstruction in altered anatomy by a short SBE, and the median time to recurrence of obstruction was 247 days. Comparison of the patency of metallic stent types showed that recurrent obstruction was longer in covered metallic stents[51].…”

Section: Introductionmentioning

confidence: 99%

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Current status of endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy

Krutsri¹,

Kida²,

Yamauchi³

et al. 2019

WJG

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Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy must be performed by a highly experienced endoscopist. The challenges are accessing the afferent limb in different types of reconstruction, cannulating a papilla with a reverse orientation, and performing therapeutic interventions with uncommon endoscopic accessories. The development of endoscopic techniques has led to higher success rates in this group of patients. Device-assisted ERCP is the endoscopic procedure of choice for high success rates in short-limb reconstruction; however, these success rate is lower in long-limb reconstruction. ERCP assisted by endoscopic ultrasonography is now popular because it can be performed independent of the limb length; however, it must be performed by a highly experienced and skilled endoscopist. Stent deployment and small stone removal can be performed immediately after ERCP assisted by endoscopic ultrasonography, but the second session is needed for other difficult procedures such as cholangioscopy-guided electrohydraulic lithotripsy. Laparoscopic-assisted ERCP has an almost 100% success rate in long-limb reconstruction because of the use of a conventional side-view duodenoscope, which is compatible with standard accessories. This requires cooperation between the surgeon and endoscopist and is suitable in urgent situations requiring concomitant cholecystectomy. This review focuses on the advantages, disadvantages, and outcomes of various procedures that are suitable in different situations and reconstruction types. Emerging new techniques and their outcomes are also discussed.

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Section: Introductionmentioning

confidence: 99%

“…Cases of failure can be successfully treated by PTCS and surgical intervention. Thus, malignant obstruction can be successfully treated by endoscopic SEMS placement with effective short-term outcomes and a longer time to recurrence of obstruction using covered type SEMS[50,53].…”

Section: Introductionmentioning

confidence: 99%

Current status of endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy

Krutsri¹,

Kida²,

Yamauchi³

et al. 2019

WJG

Self Cite

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“…Short-type doubleand single-balloon enteroscopes are now available with a working channel caliber of 3.2 mm allowing biliary selfexpandable metal stent insertion, which was impossible until recently. 46,58 The 200-cm-long DAE are particularly useful in patients with long limb Roux-en-Y gastric bypass, whereas other types of surgical reconstruction may benefit from the use of short-type DAE. 59 Dedicated accessory catheters are evaluated and are becoming available to be used for DAE-assisted ERCP.…”

Section: Dae-assisted Ercpmentioning

confidence: 99%

“…Many new DAE (proto‐) types combine two or more of these interesting features. Short‐type double‐ and single‐balloon enteroscopes are now available with a working channel caliber of 3.2 mm allowing biliary self‐expandable metal stent insertion, which was impossible until recently . The 200‐cm‐long DAE are particularly useful in patients with long limb Roux‐en‐Y gastric bypass, whereas other types of surgical reconstruction may benefit from the use of short‐type DAE .…”

Section: New Indications For Daementioning

confidence: 99%

Update in enteroscopy: New devices and new indications

Moreels

2017

Digestive Endoscopy

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The present review provides an update of the currently available (proto-) types of device-assisted enteroscopy (DAE). In recent years, newly designed double- and single-balloon enteroscopes have emerged. They aim to improve insertion depth into the small bowel, and they also allow more efficient endoscopic interventions. Nowadays, almost all conventional endoscopic procedures are feasible using DAE, opening the door to new indications. Recently, more data have become available on pediatric DAE, DAE-assisted colonoscopy, and DAE in patients with altered anatomy, including DAE-assisted endoscopic retrograde cholangiopancreatography and direct cholangioscopy. Although new enteroscopes are being developed, few comparative studies are available in order to define which DAE suits best for each indication. It is the duty of the international endoscopy community to set up clinical research projects to provide answers to these open questions.

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“…This technique has appeared to be effective without major complications [29]. A short-type single-balloon enteroscope can be useful for placing various SEMSs in these patients, with satisfactory outcomes [30]. SEMSs can be a good option for ampullary interventions that carry a low risk of major complications in post-gastrectomy patients.…”

Section: Technical Key Pointsmentioning

confidence: 99%

Endoscopic Retrograde Cholangiopancreatography in Post Gastrectomy Patients

Park

2016

Clin Endosc

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Endoscopic retrograde cholangiopancreatography (ERCP) in post-gastrectomy patients with Billroth II (BII) reconstruction and Roux-en-Y (RY) reconstruction presents a challenge to therapeutic endoscopists. Major difficulties, including intubation to the ampulla of Vater, selective cannulation, and ampullary intervention, must be overcome in these patients. Recent data have shown that device-assisted ERCP allows for high success rates in these patients because various devices are useful for overcoming major difficulties. Therefore, good knowledge of postoperative anatomy and various devices is mandatory before performing ERCP procedures for post-gastrectomy patients.

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A Case Series: Outcomes of Endoscopic Biliary Self-Expandable Metal Stent for Malignant Biliary Obstruction with Surgically Altered Anatomy

Abstract: A short-type single-balloon enteroscope was useful for the placement of various SEMS in this patient population with satisfactory outcomes.

Cited by 17 publications

References 24 publications

Current status of endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy

Current status of endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy

Update in enteroscopy: New devices and new indications

Endoscopic Retrograde Cholangiopancreatography in Post Gastrectomy Patients

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