Advanced technical tips and recent insights in ERCP using balloon‐assisted endoscopy

Shimatani, Masaaki; Mitsuyama, Toshiyuki; Yamashina, Takeshi; Takeo, Masahiro; Horitani, Shunsuke; Saito, Natsuko; Matsumoto, Hironao; Orino, Masahiro; Kano, Masataka; Yuba, Takafumi; Takayama, Takuya; Nakagawa, Tatsuya; Takayama, Shoji

doi:10.1002/deo2.301

Cited by 4 publications

(3 citation statements)

References 59 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The presence of a scar‐like mucosa surrounding the anastomosis can also serve as a clue for finding the anastomotic site. 1 …”

Section: Discussionmentioning

confidence: 99%

“…Managing such conditions requires precise identification of the stricture and sophisticated endoscopic techniques to administer effective treatment. 1 …”

Section: Discussionmentioning

confidence: 99%

“…Pancreatobiliary endoscopic interventions using balloon‐assisted endoscopes are the first‐line therapy for pancreatobiliary diseases in postoperative patients with reconstructed gastrointestinal anatomy. 1 However, there are many technical difficulties, and procedural completion rates vary widely among institutions, indicating that procedural techniques are yet to be standardized.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effectiveness of direct needle puncture for complete hepaticojejunostomy anastomotic stricture after pancreaticoduodenectomy (with video)

Soga,

Hayakawa,

Fujiwara

et al. 2024

DEN Open

View full text Add to dashboard Cite

A 79‐year‐old Japanese woman, who had undergone pancreaticoduodenectomy 6 months prior to presentation owing to pancreatic cancer, complained of jaundice with high fever. Computed tomography revealed proximal bile duct dilatation with complete hepaticojejunostomy anastomotic stricture (HJAS). We performed a single‐balloon endoscopy for biliary drainage. The presence of a scar‐like feature surrounding the anastomosis was identified as the HJAS. White‐light imaging during single‐balloon endoscopy revealed that the HJAS contained a milky whitish area (MWA), suggesting that a membranous and fibrosis layer affected continuous inflammation around the center of the anastomosis (within a scar‐like feature). Endoscopic dilatation was performed using an endoscopic injection needle, with the MWA used as an indicator. A 23‐gauge endoscopic injection needle was used to penetrate the center of the blind lumen within the MWA, and a pinhole was created in the stricture. After confirming the position of the proximal bile duct using a contrast medium with the needle, an endoscopic guidewire with a cannula was inserted into the pinhole. A through‐the‐scope sequential balloon dilator was used to dilate the stricture, and a plastic stent was inserted into the proximal bile duct. This endoscopic intervention led to positive outcomes. In cases of complete HJAS occlusion, an endoscopic approach to the bile duct is difficult because the anastomotic opening of the HJAS is not visible. Thus, puncturing within the MWA, which can be used as a scar‐like landmark within a complete membranous HJAS, is considered a useful endoscopic strategy.

show abstract

“…The presence of a scar‐like mucosa surrounding the anastomosis can also serve as a clue for finding the anastomotic site. 1 …”

Section: Discussionmentioning

confidence: 99%

“…Managing such conditions requires precise identification of the stricture and sophisticated endoscopic techniques to administer effective treatment. 1 …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effectiveness of direct needle puncture for complete hepaticojejunostomy anastomotic stricture after pancreaticoduodenectomy (with video)

Soga,

Hayakawa,

Fujiwara

et al. 2024

DEN Open

View full text Add to dashboard Cite

show abstract

All‐in‐one sphincterotome with high rotation performance and freely bendable blade for endoscopic sphincterotomy in patients with surgically altered anatomy (a case series with video)

Kunogi,

Irisawa,

Yamamiya

et al. 2024

DEN Open

View full text Add to dashboard Cite

A new type of sphincterotome released to the market recently has high rotation performance and a freely bendable blade. It is devised to be singly capable of accommodating not only normal anatomy but also cases with surgically altered anatomy. This study was undertaken for clinical evaluation of the usefulness of this new sphincterotome. Eight cases in a reconstructed intestine for which cannulation or endoscopic sphincterotomy (EST) had been performed were extracted from 32 cases for which endoscopic retrograde cholangiopancreatography‐related procedures were performed using the sphincterotome developed during November 2023 through February 2024. The cases were investigated retrospectively. Among these, EST was applied to six cases. Cannulation was performed using the developed sphincterotome in the native papilla in four cases. The primary endpoints were the success rate of cannulation in surgically altered anatomy and the success rate of EST. Secondary endpoints were complications and usability for operators. Usability for operators was evaluated by questionnaire for several items on a 5‐point scale. EST was conducted successfully in all six cases subjected to EST. Mild hemorrhage was observed in one case (17%) as an adverse event after EST. Deep cannulation to the native papilla with the developed sphincterotome was conducted successfully in three cases (75.0%). Evaluation results by operators were 4.4 ± 0.55 for rotation performance, 4.00 ± 0.63 for incision performance, 4.29 ± 0.49 for deep cannulation performance, and 4.07 ± 0.19 for overall evaluation. In conclusion, this developed sphincterotome might be very useful for EST and cannulation in cases with surgically altered anatomy.

show abstract

Utilizing a novel highly rotatable and dual‐action sphincterotome for precise cannulation and endoscopic sphincterotomy in surgically altered anatomy

Toyonaga,

Takayama,

Shimatani

2024

Digestive Endoscopy

View full text Add to dashboard Cite

show abstract

Advanced technical tips and recent insights in ERCP using balloon‐assisted endoscopy

Cited by 4 publications

References 59 publications

Effectiveness of direct needle puncture for complete hepaticojejunostomy anastomotic stricture after pancreaticoduodenectomy (with video)

Effectiveness of direct needle puncture for complete hepaticojejunostomy anastomotic stricture after pancreaticoduodenectomy (with video)

All‐in‐one sphincterotome with high rotation performance and freely bendable blade for endoscopic sphincterotomy in patients with surgically altered anatomy (a case series with video)

Utilizing a novel highly rotatable and dual‐action sphincterotome for precise cannulation and endoscopic sphincterotomy in surgically altered anatomy

Contact Info

Product

Resources

About