Factors affecting complete stone extraction in the initial procedure in short type single-balloon enteroscopy-assisted endoscopic retrograde cholangiography for patients with Roux-en-Y gastrectomy

Tanisaka, Yuki; Mizuide, Masafumi; Fujita, Akashi; Jinushi, Ryuhei; Ogawa, Tomoya; Katsuda, Hiromune; Saito, Yoichi; Miyaguchi, Kazuya; Terada, Rie; Tashima, Tomoaki; Mashimo, Yumi; Ryozawa, Shomei

doi:10.1080/00365521.2022.2088245

Cited by 7 publications

(10 citation statements)

References 29 publications

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“…The results showed that the success rates in reaching the papilla of the Vater were 92.4% (73/79), biliary cannulation was 87.7% (64/73), and in the procedures, either stent placement or stone extraction, were 96.9% (62/64); therefore, the overall procedure success rate was 78.5% (62/79). A retrospective study by Tanisaka et al 8 evaluated BE‐ERCP using short‐type single‐balloon endoscopy for the treatment of BDS in 85 patients who underwent gastrectomy with Roux‐en‐Y reconstruction. The study showed that the success rates of scope insertion, overall cannulation, and stone extraction were 96.5% (82/85), 93.9% (77/82), and 96.1% (74/77), respectively; thus, the overall success rate for stone extraction was 87.1% (74/85).…”

Section: Discussionmentioning

confidence: 99%

“…There were no significant differences in the adverse event rates between EUS-AG and BE-ERCP (17.4% vs 7.3%, P = .22) in our study, and these rates were similar to the rates in previous studies regarding EUS-AG or BE-ERCP for BDS in patients with surgically altered anatomy. [7][8][9][10] However, the types of adverse events varied between procedures. In BE-ERCP, pancreatitis and perforation were the two types of adverse events observed in our study and were also common in other studies related to BE-ERCP.…”

Section: Eus-ag Be-ercp P-valuementioning

confidence: 99%

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Comparing endoscopic ultrasound‐guided antegrade treatment and balloon endoscopy‐assisted endoscopic retrograde cholangiopancreatography in the management of bile duct stones in patients with surgically altered anatomy: A retrospective cohort study

Iwashita

Iwasa

Senju

et al. 2023

J Hepato Biliary Pancreat

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BackgroundEndoscopic ultrasound‐guided antegrade treatment (EUS‐AG) and balloon endoscopy‐assisted endoscopic retrograde cholangiopancreatography (BE‐ERCP) have emerged as useful procedures for managing bile duct stones (BDS) in patients with surgically altered anatomy. However, the comparison between these two procedures has not been well studied.The aim of our study was to compare the clinical outcomes of EUS‐AG and BE‐ERCP for managing BDS in patients with surgically altered anatomy.MethodsThe database was retrospectively evaluated at two tertiary care centers to identify patients with surgically altered anatomy who underwent either EUS‐AG or BE‐ERCP for BDS. Clinical outcomes were compared between the procedures. The success rate of each procedure was evaluated in three steps: endoscopic approach, biliary access, and stone extraction.ResultsAmong the 119 identified patients, 23 had EUS‐AG, and 96 had BE‐ERCP. The overall technical success rates of EUS‐AG and BE‐ERCP were 65.2% (15/23) and 69.8% (67/96), respectively (P = .80). The comparison of each step between the procedures EUS‐AG versus BE‐ERCP was as follows: endoscopic approach, 100% (23/23) versus 88.5% (85/96) (P = .11); biliary access, 73.9% (17/23) versus 80.0% (68/85) (P = .57); stone extraction, 88.2% (15/17) versus 98.5% (67/68) (P = .10). The overall adverse event rate was 17.4% (4/23) versus 7.3% (7/96) (P = .22).ConclusionsBoth EUS‐AG and BE‐ERCP are effective and relatively safe procedures in the management of BDS in patients with surgically altered anatomy. The challenging steps of each procedure might be different, which could help decide which one to use to manage BDS in patients with surgically altered anatomy.

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Section: Discussionmentioning

confidence: 99%

Section: Eus-ag Be-ercp P-valuementioning

confidence: 99%

Comparing endoscopic ultrasound‐guided antegrade treatment and balloon endoscopy‐assisted endoscopic retrograde cholangiopancreatography in the management of bile duct stones in patients with surgically altered anatomy: A retrospective cohort study

Iwashita

Iwasa

Senju

et al. 2023

J Hepato Biliary Pancreat

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“…34 A larger bile duct diameter (mean, 15.9 mm) has been associated with unsuccessful stone extraction. 13 As the SBE has no elevator functions, it is difficult to control the basket catheter in cases with large bile ducts and capturing the stones is also challenging. More dedicated devices for stone extraction in patients with SAA are warranted.…”

Section: A a B B C C D Dmentioning

confidence: 99%

“…Short SBE can be used with many of accessories needed in procedures, such as stone extraction or SEMS placement. [11][12][13] The reported total procedural success rate of short SBE-assisted ERCP ranged between 70.4% to 85.9% (Table 1). [14][15][16][17] A recent multi-center study of short SBE-assisted ERCP in patients with SAA reported a total procedural success and adverse event rate of 74.9% and 7.7%, respectively.…”

Section: Introductionmentioning

confidence: 99%

Single-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy: a technical review

et al. 2023

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Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy is technically challenging. For example, scope insertion, selective cannulation, and intended procedures, such as stone extraction or stent placement, can be difficult. Single-balloon enteroscopy (SBE)-assisted ERCP has been used to effectively and safely address these technical issues in clinical practice. However, the small working channel limits its therapeutic potential. To address this shortcoming, a short-type SBE (short SBE) with a working length of 152 cm and a channel of 3.2 mm diameter has recently been introduced. Short SBE facilitates the use of larger accessories to complete certain procedures, such as stone extraction or self-expandable metallic stent placement. Despite the development in the SBE endoscope, various steps have to be overcome to successfully perform such procedure. To improve success, the challenging factors of each procedure must be identified. At the same time, endoscopists need to be mindful of adverse events, such as perforation, which can arise due to adhesions specific to the surgically altered anatomy. This review discussed technical tips regarding SBE-assisted ERCP in patients with surgically altered anatomy to increase success and reduce the risk of adverse events associated with ERCP.

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“…Such techniques are however associated with suboptimal technical and clinical efficacy. This is due not only to the procedures being technically challenging, but also because of significant limitations with regard to instruments and accessories that can be used as in the case of e-ERCP [19,20] and EUS-guided biliary drainage [17], or because they are invasive, organizationally cumbersome and expensive as in the case of LA-ERCP [21]. For instance, performing an enteroscopy-assisted ERCP in patients with RYGB, entails the advancement of the enteroscope from the gastric pouch across the jejunojejunostomy and ultimately accessing the long afferent limb in a retrograde fashion until the papilla is reached.…”

Section: Pancreaticobiliary Interventionsmentioning

confidence: 99%

Use of lumen apposing metal stents in patients with altered gastrointestinal anatomy

Ichkhanian,

Jovani

2023

Current Opinion in Gastroenterology

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Purpose of review Lumen apposing metal stents (LAMS) have been increasingly used to manage patients with surgically altered anatomy (SAA), who would have otherwise required percutaneous or surgical interventions. Via the creation of de-novo anastomoses, LAMS provides a conduit to access distal parts of the gastrointestinal tract to perform various interventions. Recent findings Pancreatobiliary (PB) and non-PB interventions are challenging in patients with SAA. Endoscopic ultrasound-directed transgastric endoscopic retrograde cholangiopancreatography (ERCP) (EDGE) and endoscopic ultrasound (EUS)-directed transenteric ERCP (EDEE) are effective procedures that are being increasingly utilized to perform ERCP in patient with Roux-en-Y gastric bypass (RYGB) and non-RYGB SAA, respectively. Furthermore, EUS-directed trans-gastric intervention (EDGI) is a collective term for the non-PB procedures that could be performed in patients with SAA. EDGE/EDEE/EDGI are considered relatively safe procedures, however, intra-procedural stent misdeployement, and long-term ramifications of persistent fistula and stent migration could require endoscopic or, in rare instances, surgical management. Summary The advent of LAMS has revolutionized the therapeutic capabilities of EUS, by allowing the creation of new gastrointestinal anastomoses. With the growing body of literature, it is expected that such techniques will be more commonly performed in the community, providing less invasive and more effective treatment options for patients with SAA.

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Factors affecting complete stone extraction in the initial procedure in short type single-balloon enteroscopy-assisted endoscopic retrograde cholangiography for patients with Roux-en-Y gastrectomy

Cited by 7 publications

References 29 publications

Comparing endoscopic ultrasound‐guided antegrade treatment and balloon endoscopy‐assisted endoscopic retrograde cholangiopancreatography in the management of bile duct stones in patients with surgically altered anatomy: A retrospective cohort study

Comparing endoscopic ultrasound‐guided antegrade treatment and balloon endoscopy‐assisted endoscopic retrograde cholangiopancreatography in the management of bile duct stones in patients with surgically altered anatomy: A retrospective cohort study

Single-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy: a technical review

Use of lumen apposing metal stents in patients with altered gastrointestinal anatomy

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