Outcomes of ERCP in Billroth II gastrectomy patients

Park, Tae Young; Kang, Jong Sik; Song, Tae Jun; Lee, Sang Soo; Lee, Hyuk; Choi, Jung-Sik; Kim, Hong Jun; Jang, Jyongsik

doi:10.1016/j.gie.2015.10.036

Cited by 40 publications

(40 citation statements)

References 29 publications

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“…Billroth II resection and a procedure described as "difficult" are the main risk factors for duodenal perforation during ERCP [134, 159 -161]. In a retrospective series of 165 patients with a Billroth II gastrectomy, 1.8 % of patients experienced the adverse event of perforation [162]. A more recent retrospective study showed that, in patients with Billroth II reconstruction, loop-shaped insertion of the endoscope is a risk factor for perforation (P = 0.01) [163].…”

Section: Duodenal Perforationsmentioning

confidence: 99%

Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement – Update 2020

et al. 2020

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Summary of Recommendations 1 ESGE recommends that each center implements a written policy regarding the management of iatrogenic perforations, including the definition of procedures that carry a higher risk of this complication. This policy should be shared with the radiologists and surgeons at each center. 2 ESGE recommends that in the case of an endoscopically identified perforation, the endoscopist reports its size and location, with an image, and statement of the endoscopic treatment that has been applied. 3 ESGE recommends that symptoms or signs suggestive of iatrogenic perforation after an endoscopic procedure should be rapidly and carefully evaluated and documented with a computed tomography (CT) scan. 4 ESGE recommends that endoscopic closure should be considered depending on the type of the iatrogenic perforation, its size, and the endoscopist expertise available at the center. Switch to carbon dioxide (CO2) endoscopic insufflation, diversion of digestive luminal content, and decompression of tension pneumoperitoneum or pneumothorax should also be performed. 5 ESGE recommends that after endoscopic closure of an iatrogenic perforation, further management should be based on the estimated success of the endoscopic closure and on the general clinical condition of the patient. In the case of no or failed endoscopic closure of an iatrogenic perforation, and in patients whose clinical condition is deteriorating, hospitalization and surgical consultation are recommended.

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Section: Duodenal Perforationsmentioning

confidence: 99%

Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement – Update 2020

et al. 2020

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“…The current study offers data to support a cap-assisted, forward-viewing endoscopic approach as an appropriate alternative to use of a duodenoscope. The outcomes of the study by Park et al 11 when taken in the context of the rates of clinical failure and perforation described in prior studies (single center, cases series) with a "duodenoscopic ERCP" approach lends weight to the argument for a first attempt at ERCP with a forward-viewing, cap-assisted technique. However, a recent large duodenoscopic case series with lower rates of adverse events (1.8%) and the absence of high-quality comparative data suggest that one approach cannot be definitively recommended over another.…”

mentioning

confidence: 99%

Cap-assisted pancreaticobiliary endoscopy in Billroth II anatomy: ERCP “through the looking glass”

Easler

Sherman

2016

Gastrointestinal Endoscopy

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“…146,170 In a multiple large series of Billroth II patients at tertiary centers, the rate of perforation during ERCP was 1.8%, which is higher than the reported average of < 1%. 176,177 However, smaller case series report perforation rates as high as 18%, which may reflect closer to the experience of community ERCP endoscopists. 178 Post-Whipple (pancreaticoduodenectomy) anatomy does not appear to significantly increase the risk of perforation during ERCP.…”

Section: Risk Reductionmentioning

confidence: 69%

Endoscopic retrograde cholangiopancreatography complications: Techniques to reduce risk and management strategies

Tarnasky

Kedia

2017

Int J Gastrointest Interv

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Adverse events after endoscopic retrograde cholangiopancreatography (ERCP) are not uncommon and can be associated with tragic outcomes. Bleeding, perforation, and post-ERCP pancreatitis are the most common complications. Some events are unavoidable; others are associated with well described risk factors so that they can be either anticipated and/or measures can be taken for prevention or at least risk reduction. This review will focus on the more common complications after ERCP, their risk factors, and potential strategies for risk reduction. Additionally, recommendations for management of ERCP complications will be presented.

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Outcomes of ERCP in Billroth II gastrectomy patients

Cited by 40 publications

References 29 publications

Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement – Update 2020

Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement – Update 2020

Cap-assisted pancreaticobiliary endoscopy in Billroth II anatomy: ERCP “through the looking glass”

Endoscopic retrograde cholangiopancreatography complications: Techniques to reduce risk and management strategies

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