Endoscopic Retrograde Cholangiopancreatography in Patients with Previous Pancreaticoduodenectomy: A Single-Center Experience

Park, Byung Kyu; Jeon, Tae Joo; Jayaraman, Vijay; Hammerle, Christopher; Gupta, Kapil; Jamil, Laith H.; Lo, Simon K.

doi:10.1007/s10620-015-3861-z

Cited by 17 publications

(12 citation statements)

References 23 publications

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“…6,9 Similar to total enteroscopy rates in DBE for small-bowel indications, Japanese success with DBE-ERCP is higher than that in the Western population. 5,[12][13][14][15][16] This likely reflects differences in patient body habitus and indications for surgically altered anatomy among the two population groups (gastrectomy in Japanese vs gastric bypass in Western population). 9,11 In comparison, Western series with 20 or more procedures report lower success rates at 63-83%.…”

Section: Discussionmentioning

confidence: 99%

“…9,11 In comparison, Western series with 20 or more procedures report lower success rates at 63-83%. 5,[12][13][14][15][16] This likely reflects differences in patient body habitus and indications for surgically altered anatomy among the two population groups (gastrectomy in Japanese vs gastric bypass in Western population). 17 We report the largest DBE-ERCP series (n = 86) in patients with REYA.…”

Section: Discussionmentioning

confidence: 99%

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Predictors of success for double balloon‐assisted endoscopic retrograde cholangiopancreatography in patients with Roux‐en‐Y anastomosis

Liu

Joshi

Saxena

et al. 2016

Digestive Endoscopy

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Indication for REYA impacts on successful biliary cannulation in patients undergoing DBE-ERCP. The procedure is most successful in non-liver transplant adult surgery and post-transplant patients without a second operation. It is least successful in patients with surgically corrected biliary atresia and post-transplant patients with second operation. Alternative methods of biliary access should be considered in these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Predictors of success for double balloon‐assisted endoscopic retrograde cholangiopancreatography in patients with Roux‐en‐Y anastomosis

Liu

Joshi

Saxena

et al. 2016

Digestive Endoscopy

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“…Several cohort studies using traditional endoscopic retrograde cholangiopancreatography endoscopes or colonoscope-assisted ERP have shown disappointing results, with reported clinical success rates often below 25 % [4][5][6][7]. Higher success rates have been described using single-and double-balloon enteroscope-assisted ERP, with reported technical success rates between 50 % and 70 % [8,9]. However, cannulation of a PJS stenosis remains a challenging procedure, even when using balloon enteroscopy.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic retrograde pancreatography-guided versus endoscopic ultrasound-guided technique for pancreatic duct cannulation in patients with pancreaticojejunostomy stenosis: a systematic literature review

et al. 2020

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Background and aim Stenosis of the pancreaticojejunostomy is a well-known long-term complication of pancreatoduodenectomy. Traditionally, the endoscopic approach consisted of endoscopic retrograde pancreaticography (ERP). Endoscopic ultrasound (EUS)-guided intervention has emerged as an alternative, but the success rate and adverse event rate of both treatment modalities are poorly known. We aimed to compare the outcome data of both interventions Methods We performed a systematic literature search using the Pubmed/Medline and Embase databases with the aim of summarizing the available data regarding efficacy and complications of ERP-and EUS-guided pancreatic duct (PD) drainage and compare these outcome data using uniform outcome measures in a multilevel logistic model. Results In total 13 studies were included, with 89 patients having undergone ERP-guided drainage and 113 patients EUS-guided drainage. An EUS-guided approach was significantly superior to an ERP-guided approach with regard to cannulation success (80% vs 20%, p<0.000), pancreatic duct opacification (86% vs 25%, p<0.000) and stent placement (73% vs 20%, p<0.000). An EUS-guided approach also appeared superior with regard to clinical outcomes such a pain resolution. The adverse event rate between the two treatment modalities could not be compared due to insufficient data. All included studies were found to be of low quality. Conclusion Based on limited available data, EUS-guided PD intervention appears superior to ERP-guided PD intervention.

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“…Balloon enteroscopy facilitates diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP) to treat postoperative pancreatobiliary disorders following gastrointestinal reconstruction [ 5 – 15 ]. Endoscopic methods such as balloon dilatation or plastic stent placement can now be performed for HJAS.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic balloon dilatation for benign hepaticojejunostomy anastomotic stricture using short double-balloon enteroscopy in patients with a prior Whipple’s procedure: a retrospective study

et al. 2018

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BackgroundEndoscopic retrograde cholangiography using a short double-balloon endoscope (DB-ERC) is a promising minimally-invasive method for accessing hepaticojejunostomy (HJ) anastomosis in patients with surgically altered anatomy. We aimed to evaluate the immediate and long-term outcomes of balloon dilatation for benign HJ anastomotic stricture (HJAS) in patients who had previously undergone Whipple’s procedure using a DB-ERC.MethodsWe conducted a retrospective analysis of 46 patients who underwent balloon dilatation alone with a DB-ERC for benign HJAS between November 2008 and November 2014. The median follow-up duration was 3.5 (interquartile range [IQR], 1.9–5.1) years.ResultsThe technical and clinical success rates were 100%, and adverse events occurred in 7% (3/46, cholangitis). The median hospitalization period was seven (IQR, 5–10) days. Of 42 patients (91%) followed-up for > 1 year, 24 (51%) had recurrent HJAS at a median of 1.2 (IQR, 0.6–2.9) years after balloon dilatation. The cumulative anastomotic patency rates at 1, 2, and 3 years were 73, 55, and 49%, respectively. In univariate analysis, early stricture formation (< 1 year) was a risk factor for recurrent stenosis, although no statistically significant risk factors were observed in multivariate analysis.ConclusionsEndoscopic balloon dilatation with DB-ERC for benign HJAS is effective and safe, having good immediate technical success and few adverse events. Further improvements to this procedure are needed to prevent recurrent HJAS.

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Endoscopic Retrograde Cholangiopancreatography in Patients with Previous Pancreaticoduodenectomy: A Single-Center Experience

Abstract: ERCP in post-PD patients can be performed with a high success rate. We recommend that CEs should be used initially for ERCP in patients with PD and that BAEs be reserved for situation in which CEs have failed to reach the pancreaticobiliary anastomoses.

Cited by 17 publications

References 23 publications

Predictors of success for double balloon‐assisted endoscopic retrograde cholangiopancreatography in patients with Roux‐en‐Y anastomosis

Predictors of success for double balloon‐assisted endoscopic retrograde cholangiopancreatography in patients with Roux‐en‐Y anastomosis

Endoscopic retrograde pancreatography-guided versus endoscopic ultrasound-guided technique for pancreatic duct cannulation in patients with pancreaticojejunostomy stenosis: a systematic literature review

Endoscopic balloon dilatation for benign hepaticojejunostomy anastomotic stricture using short double-balloon enteroscopy in patients with a prior Whipple’s procedure: a retrospective study

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