ERCP using a short double-balloon enteroscope in patients with prior pancreatoduodenectomy: higher maneuverability supplied by the efferent-limb route

Tsutsumi, Keisuke; Kato, Hironari; Muro, Shinichiro; Yamamoto, Naoki; Noma, Yasuhiro; Horiguchi, Shigeru; Harada, Ryo; Yamamoto, Kazuhide

doi:10.1007/s00464-014-3889-8

Cited by 19 publications

(12 citation statements)

References 18 publications

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“…14 Table 3 shows the outcomes of short-type DBE-assisted ERCP in patients with SAA. 9,10,[12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] The success rates of reaching the target site, biliary cannulation, and therapeutic procedure in short-type DBE-assisted ERCP were 94.8%, 95.6%, and 94.5%, respectively, from these pooled data. On the other hand, the latest systematic review and meta-analysis reported that the success rates of reaching the target site, biliary cannulation, and therapeutic procedure in both short-type and standardtype DBE-assisted ERCP were 90%, 94%, and 93%, respectively.…”

Section: Short-type Double Balloon-assisted Ercpmentioning

confidence: 87%

Recent advances of endoscopic retrograde cholangiopancreatography in surgically altered anatomy

Kim

Yang

2021

Int J Gastrointest Interv

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Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy (SAA) of the upper gastrointestinal tract is a more technically challenging and arduous procedure accompanied by a low success rate of reaching the target orifice and a relatively high rate of complications, compared to those with normal anatomy. Since the introduction of device-assisted enteroscopies such as balloon enteroscopy (BE) and manual spiral enteroscopy (SE) for small bowel disorders, they have also been used for ERCP in patients with SAA. The recent development of short-type BE makes ERCP in patients with SAA technically easier with high success rates and short procedural duration, and then short-type BE is considered the gold standard endoscopic procedure in these patients. Laparoscopy-assisted ERCP is another therapeutic option, especially for patients with a long excluded afferent limb of SAA. The choice of procedure for high success rates should be individualized according to patient characteristics and available physician competence. Moreover, novel motorized SE is a promising alternative procedure for the successful performance of ERCP.

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Section: Short-type Double Balloon-assisted Ercpmentioning

confidence: 87%

Recent advances of endoscopic retrograde cholangiopancreatography in surgically altered anatomy

Kim

Yang

2021

Int J Gastrointest Interv

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“…Two endoscopic approaches (the afferent-limb route and efferent-limb route) are possible for HJ anastomosis in patients with Braun anastomosis, and we usually selected the efferent-limb route because it allows accurate identification of the route to the HJ anastomosis. That is, selection of the middle of a three-pronged lumen at the Braun anastomosis for the route leads the scope to the HJ anastomosis and allows for better maneuverability [ 7 ]. After reaching close to the blind end of the jejunum, endoscopic visualization of the pinpoint orifice or cicatricial mucosa was attempted to identify the HJ anastomosis, sometimes using fluoroscopic guidance (Fig.…”

Section: Methodsmentioning

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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“…Table 3 shows the outcomes of DBE-assisted ERCP procedures in patients with SAA [29][30][31][32][33][34][35][36][37][38]. The latest systematic review and meta-analysis reported that the pooled data reaching the target site, biliary cannulation, and procedural success rates were 90%, 94%, and 93%.…”

Section: Double Balloon-assisted Ercpmentioning

confidence: 99%

Recent Advances of Interventional Endoscopic Retrograde Cholangiopancreatography and Endoscopic Ultrasound for Patients with Surgically Altered Anatomy

Tanisaka

Mizuide

Fujita

et al. 2021

JCM

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Endoscopic retrograde cholangiopancreatography (ERCP) is considered to be the gold standard for diagnosis and interventions in biliopancreatic diseases. However, ERCP in patients with surgically altered anatomy (SAA) appears to be more difficult compared to cases with normal anatomy. Since the production of a balloon enteroscope (BE) for small intestine disorders, BE had also been used for biliopancreatic diseases in patients with SAA. Since the development of BE-assisted ERCP, the outcomes of procedures, such as stone extraction or drainage, have been reported as favorable. Recently, an interventional endoscopic ultrasound (EUS), such as EUS-guided biliary drainage (EUS-BD), has been developed and is available mainly for patients with difficult cases of ERCP. It is a good option for patients with SAA. The effectiveness of interventional EUS for patients with SAA has been reported. Both BE-assisted ERCP and interventional EUS have advantages and disadvantages. The choice of procedure should be individualized to the patient’s condition or the expertise of the endoscopists. The aim of this review article is to discuss recent advances in interventional ERCP and EUS for patients with SAA.

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ERCP using a short double-balloon enteroscope in patients with prior pancreatoduodenectomy: higher maneuverability supplied by the efferent-limb route

Cited by 19 publications

References 18 publications

Recent advances of endoscopic retrograde cholangiopancreatography in surgically altered anatomy

Recent advances of endoscopic retrograde cholangiopancreatography in surgically altered anatomy

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

Recent Advances of Interventional Endoscopic Retrograde Cholangiopancreatography and Endoscopic Ultrasound for Patients with Surgically Altered Anatomy

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