Clockwise insertion: A risk factor of pancreatic hyperamylasemia and acute pancreatitis after peroral balloon‐assisted enteroscopy

Matsushita, Masayuki; Shimatani, Masaaki; Okazaki, Kazuichi

doi:10.1111/den.12614

Cited by 3 publications

(4 citation statements)

References 5 publications

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“…The NOS score ranged from 4 to 8 points. Twenty studies were considered to be of moderate quality, and 3 were of high quality ( 12 , 20 , 25 ). Publication bias (Egger test): t=2.63; P=0.0155.…”

Section: Resultsmentioning

confidence: 99%

“…The continuous pressure of the small intestine and the mesentery during the push and pull maneuvers could compromise the vascular supply to the pancreas, resulting in an increase in the pancreatic enzymes. Radiological studies showed that AP after DAE was mostly localized to the pancreas body and/or tail ( 25 ). Some investigators suspected that AP after DAE may occur as a result of traumatic injury and/or ischemia on the pancreas body and/or tail ( 39 - 41 ).…”

Section: Discussionmentioning

confidence: 99%

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The Incidence of Acute Pancreatitis After Device Assisted Enteroscopy: a Systematic Review and Meta-analysis

MD,

et al. 2023

Med Arch

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Background: The diagnosis of small bowel diseases is challenging and device assisted enteroscopy (DAE) is a technique for visualizing the entire small bowel. DAE is considered as a safe procedure and the reported rate of adverse events associated with DAE in the literature is low. Objective: The present study tried to investigate the actual incidence of AP after DAE with a systematic review and meta-analysis of available relevant studies. Methods: Studies were searched through the PubMed, EMBASE, and Cochrane library databases. The following data were extracted from all eligible studies: author, country, publication year, publication type, study design, type of DAE used, route of DAE, number of patients with AP after DAE, and number of patients with hyperamylasemia after DAE.A random-effects model with RStudio version 4.2.0 was performed in all analyses. Heterogeneity was assessed using the I2 test. The risk of bias was assessed by the Newcastle-Ottawa Scale criteria and the publication bias was assessed by the Egger test. Results: Twenty three studies involving a total of 11145 patients were included in the analysis. The overall, pooled AP rate after DAE was 1% (95% CI:0-1%). There was significant heterogeneity among the studies (I2 = 65%; P < 0.01).The pooled AP rate was 1% (95% CI:0-2 %)in peroral route group. The pooled proportion of patients having hyperamylasemia after DAE was 29% (95% CI: 16-46%).Among the patients who had hyperamylasemia AP were identified in 2% (95% CI: 0-6%) of patients. Conclusion: The incidence of AP after DAE is about 1%. Hyperamylasemia is a common change in the patients undergoing DAE and only 2% of the patients with hyperamylasemia present with AP.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Incidence of Acute Pancreatitis After Device Assisted Enteroscopy: a Systematic Review and Meta-analysis

MD,

et al. 2023

Med Arch

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“…The secondary outcome measures were the reasons for failure to reach the blind end and the success rate of reaching the blind end using a long-type SBE (lSBE) in patients in whom failure to reach the blind end using an sSBE was caused by an insufficient length of the scope and complications associated with sSBE insertion. Pancreatitis associated with endoscope insertion was defined as pancreatitis affecting only the body and tail of the pancreas [15, 16]. The severity of complications was evaluated according to the severity grading system of the American Society for Gastrointestinal Endoscopy [17].…”

Section: Methodsmentioning

confidence: 99%

Failure Factors to Reach the Blind End Using a Short-Type Single-Balloon Enteroscope for ERCP with Roux-en-Y Reconstruction: A Multicenter Retrospective Study

Kawaguchi

Yamauchi

Okuwaki

et al. 2019

Gastroenterology Research and Practice

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Background. Failure factors in reaching the blind end (papillae of Vater, bilioenteric anastomosis) during short-type single-balloon enteroscope-assisted endoscopic retrograde cholangiopancreatography (sSBE-assisted ERCP) in patients with Roux-en-Y (R-Y) reconstruction remain to be evaluated. Aims. We investigated the failure factors in such patients. Methods. We retrospectively studied 253 initial sessions of sSBE-assisted ERCP at three endoscopy centers from April 2008 through September 2017, examining failure factors and complications associated with scope insertion in patients with R-Y reconstruction. Results. R-Y reconstruction was performed in 157 patients (with gastrectomy: 122 patients; without gastrectomy plus bilioenteric anastomosis: 35 patients). R-Y without gastrectomy (p=0.001; odds ratio (OR), 5.73; 95% confidence interval (CI), 2.07 to 16.01) and the presence of peritoneal dissemination (p=0.021; OR, 4.71; 95% CI, 1.27 to 17.54) were significant failure factors. Insufficient sSBE length was the cause of failure in 17 (11%) of the 157 patients, and 13 (76%) of the 17 patients were with R-Y without gastrectomy. In cases of insufficient short-type length, using a long-type SBE significantly increased the success rate (p=0.002). Gastrointestinal stenosis was a significant failure factor (p=0.011) in patients with peritoneal dissemination. Perforation occurred in 2 patients who responded to conservative treatment. Conclusions. Failure factors during sSBE-assisted ERCP were R-Y without gastrectomy and the presence of peritoneal dissemination.

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“…1 ). Another potential disadvantage of the clockwise rotation is post-BAE acute pancreatitis, which could occur as a result of the severe mechanical strain from traumatic injury and/or ischemia on the pancreatic body and tail [ 7 ].…”

Section: Insertion Techniquementioning

confidence: 99%

Training in Endoscopy: Enteroscopy

Kim

2017

Clin Endosc

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The balloon-assisted enteroscope has been regarded as the standard device for direct visualization of deep small bowels and allows for the diagnosis and treatment of small bowel disease. At the beginning, its application was focused on the diagnosis of obscure gastrointestinal bleeding, inflammatory bowel disease, and small bowel tumor. However, the indications are being expanded to various therapeutic procedures, not only confined to bleeding control. With the expansion of the indications, the need to perform enteroscopy effectively and safely is increasing. Recent studies have been focused on the diagnostic yield, therapeutic yield, and long-term outcomes of the device. However, with the increasing number of procedures, procedural guidelines and quality indicators are also needed.

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Clockwise insertion: A risk factor of pancreatic hyperamylasemia and acute pancreatitis after peroral balloon‐assisted enteroscopy

Cited by 3 publications

References 5 publications

The Incidence of Acute Pancreatitis After Device Assisted Enteroscopy: a Systematic Review and Meta-analysis

The Incidence of Acute Pancreatitis After Device Assisted Enteroscopy: a Systematic Review and Meta-analysis

Failure Factors to Reach the Blind End Using a Short-Type Single-Balloon Enteroscope for ERCP with Roux-en-Y Reconstruction: A Multicenter Retrospective Study

Training in Endoscopy: Enteroscopy

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