Double-balloon enteroscopy application in biliary tract disease—its therapeutic and diagnostic functions

Chu, Yen-Chang; Yang, Chi‐Chieh; Yeh, Yung‐Hsiang; Chen, Chien‐Hua; Yueh, Shing-Kao

doi:10.1016/j.gie.2008.03.1083

Cited by 83 publications

(74 citation statements)

References 7 publications

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“…Th e incidence of DB-ERC-related adverse events has been reported to be 0-17% (30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41), but most relevant reports are based on small numbers of patients, and no solid data have been reported. In a study conducted by Shah et al ( 37 ), adverse events occurred in 12% of patients and included pancreatitis ( n =5; 4 mild and 1 severe cases), mild bleeding ( n =1), abdominal pain requiring hospital admission ( n =3), throat pain requiring physician contact ( n =4) and perforations ( n =2).…”

Section: Surgical Anatomymentioning

confidence: 99%

Diagnostic and Therapeutic Endoscopic Retrograde Cholangiography Using a Short-Type Double-Balloon Endoscope in Patients With Altered Gastrointestinal Anatomy: A Multicenter Prospective Study in Japan

Shimatani

Hatanaka

Kogure

et al. 2016

American Journal of Gastroenterology

133

123

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, The Japanese DB-ERC Study Group 10 OBJECTIVES:To evaluate the utility and safety of a short-type double-balloon endoscope (DBE) in the treatment of biliary disease in patients with surgically altered gastrointestinal (GI) anatomy. METHODS:This study was conducted as a multicenter, single-arm, prospective trial at fi ve tertiary academic care centers and three community-based hospitals in Japan. Consecutive patients with biliary disease with altered GI anatomy were prospectively included in this study. RESULTS:A total of 311 patients underwent double-balloon endoscopic retrograde cholangiography (ERC). The success rate of reaching the target site, the primary end point, was 97.7% (95% confi dence interval (CI): 95.4-99.1). The success rate of biliary cannulation and contrast injection of the targeted duct, the secondary end point, was 96.4% (95% CI: 93.6-98.2), and the therapeutic success rate was 97.9% (95% CI: 95.4-99.2). Adverse events occurred in 33 patients (10.6%, 95% CI: 7.1-14.0) and were managed conservatively in all patients with the exception of 1 in whom a perforation developed, requiring emergency surgery.CONCLUSIONS: ERC using a short-type DBE resulted in an excellent therapeutic success rate and a low rate of adverse events. This treatment can be a fi rst-line treatment for biliary disease in patients with surgically altered GI anatomy.

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Section: Surgical Anatomymentioning

confidence: 99%

Diagnostic and Therapeutic Endoscopic Retrograde Cholangiography Using a Short-Type Double-Balloon Endoscope in Patients With Altered Gastrointestinal Anatomy: A Multicenter Prospective Study in Japan

Shimatani

Hatanaka

Kogure

et al. 2016

American Journal of Gastroenterology

133

123

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“…Due to its size, length, flexibility and the presence of two balloons, DBE has also been used to perform ERCP in patients with complex postsurgical anatomy [5,6,7,8]. However, there are a few disadvantages in performing DBE.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Retrograde Cholangiopancreatography Using the Single Balloon Enteroscope Technique in Patients with Roux-en-Y Anastomosis

Neumann¹,

Fry²,

Meyer

et al. 2009

Digestion

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Background: Endoscopic retrograde cholangiopancreatography (ERCP) is technically challenging or impossible in patients with complex postsurgical anatomy. The aim of this cohort study was to assess the technical success of ERCP with the single balloon enteroscope (SBE) in patients with Roux-en-Y anastomosis. Patients: Patients with Roux-en-Y anastomosis presenting with cholestasis undergoing ERCP with the SBE technique in a tertiary university hospital. Diagnostic success was defined as successful duct cannulation or securing the diagnosis and therapeutic success was defined as the ability to successfully accomplish endoscopic therapy. Results: ERCP using the SBE was performed on 17 occasions in 13 patients (5 F, 8 M, mean age 66.5 years, range 25–77) with Roux-en-Y anastomosis. Indications for ERCP were biliary obstruction with common bile duct stones and/or cholangitis in all patients. The diagnostic success was 61.5% and the therapeutic success was 53.8%. Therapeutic interventions included dilation of common bile duct stenosis with a balloon (n = 4), biliary stent insertion (n = 2), removal of bile duct stones (n = 2), stent retrieval (n = 2), papillectomy (n = 1), and sphincterotomy (n = 1). No major complications occurred. Conclusions: ERCP using the SBE is feasible in patients with altered postsurgical anatomy presenting with biliary problems permitting diagnostic and therapeutic interventions.

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“…Kuga et al 23 , en una serie con seis pacientes, presentaron tasa de éxito de 83,3%. Chu et al 9 , obtuvieron éxito en la cateterización biliar en 3/5 pacientes. Mönkemüller et al 24 , evaluaron el empleo del enteroscopio de doble balón en pacientes con anastomosis en Y-de-Roux.…”

Section: Cpre Con El Empleo Del Enteroscopio De Doble Balónunclassified

“…El éxito técnico de este procedimiento es mayor al 90%, con una morbididad de 5% y mortalidad menor al 1% en centros de referencia 7,8 . El BGYR implica la exclusión duodenal y de la papila mayor del tránsito normal del tubo digestivo, prácticamente impidiendo el acceso y por tanto, el tratamiento endoscópico de la litiasis de la vía biliar principal empleando equipamientos convencionales debido a la mayor distancia y tortuosidad de las asas yeyunales 1,9,10 . En esta situación, se ha sugerido el acceso a la papila duodenal mayor a través de un enteroscopio, colonoscopio o duodenoscopio convencional introducido a través de una ostomía 11 .…”

Section: Introductionunclassified

Colangiopancreatografía retrógrada endoscópica en pacientes con asa en Y-de-Roux

et al. 2012

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Endoscopic retrograde cholangiopancreatography in Roux-en-Y patientsThe reconstruction of the digestive tract with a Roux-en-Y anastomosis has been performed more frequently in the last years mainly due to the overgrowth in the surgical treatment of obesity by gastric bypass in Roux-en-Y. The obesity pandemic is also associated with an increase in both the preoperative and postoperative diagnosis of gallstones in this population. Bearing in mind the greater complexity of endoscopic retrograde cholangiopancreatography in these circumstances, the authors have reviewed the various endoscopic approaches available, evaluating 249 articles published between 1990 and 2010 obtained from Medline, Cochrane and Scielo, excluding case reports and articles outside the specifi c scope of this study. Endoscopic techniques with high success rates include the use of enteroscope, colonoscope, enteral and transgastric access combined with surgery. Even with the technological progress already made, further development of the instruments used will be necessary if greater comfort and safety is to be achieved with this procedure.Key words: Choledocholithiasis (MeSH), Anastomosis, Roux-en-Y (MeSH), Gastric Bypass (MeSH), Cholangiopancreatography, Endoscopic Retrograde (MeSH). ResumenLa reconstrucción del trato digestivo con un asa en Y-de-Roux ha sido más empleada en los últimos años debido principalmente al aumento del tratamiento quirúrgico de la obesidad mediante el bypass gástrico en Y-de-Roux (BGYR). La pandemia de la obesidad se ha asociado a un aumento en la prevalencia de litiasis biliar en esta población, diagnosticada en el estudio preoperatorio y durante el seguimiento postoperatorio. La colangiopancreatografía endoscópica retrógrada (CPRE) posee una mayor complejidad en estas circunstancias donde existe una alteración anatómica que difi culta el acceso a la papila mayor. El objetivo de esta revisión es describir las alternativas de acceso al asa biliopancreática para realizar CPRE en pacientes con un asa en Y-deRoux enfatizando la accesibilidad técnica, los resultados y complicaciones de los procedimientos. Se realizó una búsqueda y revisión de la literatura en las bases de datos: Medline, Cochrane y Scielo. Se evaluaron 249 publicaciones desde 1990 a 2010, en idioma español, inglés y portugués. Fueron excluidos de esta revisión los reportes de casos y publicaciones no atingentes. Las opciones endoscópicas para realizar CPRE en pacientes Rev.

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Double-balloon enteroscopy application in biliary tract disease—its therapeutic and diagnostic functions

Cited by 83 publications

References 7 publications

Diagnostic and Therapeutic Endoscopic Retrograde Cholangiography Using a Short-Type Double-Balloon Endoscope in Patients With Altered Gastrointestinal Anatomy: A Multicenter Prospective Study in Japan

Diagnostic and Therapeutic Endoscopic Retrograde Cholangiography Using a Short-Type Double-Balloon Endoscope in Patients With Altered Gastrointestinal Anatomy: A Multicenter Prospective Study in Japan

Endoscopic Retrograde Cholangiopancreatography Using the Single Balloon Enteroscope Technique in Patients with Roux-en-Y Anastomosis

Colangiopancreatografía retrógrada endoscópica en pacientes con asa en Y-de-Roux

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