Evaluation of endoscopic retrograde cholangiopancreatography using a newly developed short‐type single‐balloon endoscope in patients with altered gastrointestinal anatomy

Abstract

Background and Aim: Endoscopic approaches for pancreatobiliary diseases in patients with altered gastrointestinal anatomy had been impractical until the development of balloonassisted endoscope (BAE) made it feasible. The aim of the present study was to evaluate the usefulness of a newly developed short-type single-balloon endoscope (s-SBE) for endoscopic retrograde cholangiopancreatography (ERCP) in patients with altered gastrointestinal anatomy. Methods: From March 2013 to November 2013, s-SBE-assistedERCP was done in our hospital in 26 postoperative patients who had surgically altered anatomy. We retrospectively evaluated the success rate of reaching the blind end, the mean time required to reach the blind end, the diagnostic success rate, the therapeutic success rate, the mean procedure time, and complications. Results:The success rate of reaching the blind end was 92.3%.The mean time required to reach the blind end was 25.3 min. The diagnostic success rate was 91.7%. The diagnostic success rate for naïve papilla was 75%. The mean procedure time was 56.0 min. The success rate of overall s-SBE-assisted ERCP was 84.6%. The complication rate was 3.8%.Conclusion: Diagnostic and therapeutic ERCP using a newly developed s-SBE is sufficiently effective.

Utility of newly developed short‐type double‐balloon endoscopy for endoscopic retrograde cholangiography in postoperative patients

“…Performing ERCP in patients with SAGA poses a greater risk of complications than in patients with normal anatomy . Recently, several papers also reported that the occurrence of adverse events in such patients using several‐type BAE was 0–17% from small‐size sample studies, and yet, there are few reports from a large‐scale study . In our previous study using C‐short DBE, we reported 5% .…”

“…Performing ERC for pancreatobiliary diseases in patients with SAGA is considered challenging because of the difficulty of scope insertion to the blind end and ERC‐related interventions. Up to date, there are several studies reporting on more usefulness of BAE for postoperative pancreatobiliary diseases in comparison with conventional endoscopes . Martin Raithel et al reported the success rate of reaching the blind end was 16.2%.…”

“…However, the application of those treatments was limited by such factors as anticoagulant use, the presence of intrahepatic biliary dilatation, or ascites . Therefore, the application of balloon‐assisted endoscope (BAE) that was originally developed for observations and therapies for intestinal diseases radically gained the efficacy for pancreatobiliary disease in patients with SAGA . Numerous studies were published on the utility of BAE, especially on the short‐type double‐balloon endoscope (DBE) and the short‐type single‐balloon endoscope (SBE) that had a feature of more selection of available devices.…”

Endoscopic Retrograde Cholangiopancreatography in Post Gastrectomy Patients

“…A standard balloon enteroscope has a 200-cm long and 2.8-mm diameter channel. However, the recently developed short single-balloon enteroscope has a 152-cm long and 3.2-mm diameter channel, which allows for all kinds of regular ERCP accessories [12,13]. The differences between the endoscopes used for D-ERCP are summarized in Table 2.…”

Performance of a new short‐type double‐balloon endoscope with advanced force transmission and adaptive bending for pancreaticobiliary intervention in patients with surgically altered anatomy: A propensity‐matched analysis

“…Endoscopic retrograde cholangiopancreatography (ERCP) for patients with surgically altered gastrointestinal anatomy remains challenging. Recently, short‐type double‐balloon endoscopes (DBE) for pancreaticobiliary interventions in patients with surgically altered anatomy have become available in many institutions . Success rates of reaching the target site and of ERCP‐related interventions associated with use of these endoscopes are reported to range between 73% and 100% and between 85% and 100%, respectively .…”