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

Yamada, Atsuo; Kogure, Hirofumi; Nakai, Yousuke; Takahara, Naminatsu; Tada, Minoru; Koike, Kazuhiko

doi:10.1111/den.13261

Cited by 34 publications

(35 citation statements)

References 22 publications

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“…3). [32][33][34] In cases with surgically altered anatomy, the size of BDS is often too large for stone extraction without lithotripsy. Various techniques described above can be applied in this setting.…”

Section: Enteroscopy-assisted Ercpmentioning

confidence: 99%

“…Single-session and overall complete stone removal rates in surgically altered anatomy patients are reportedly 66.7% to 100% and 96.7% to 100%, respectively, using EPLBD. 6 ML can be performed using recently developed enteroscopes 33,34 with short scope length and a large channel but the size of BDS is limited to <2-3 cm for successful lithotripsy by ML. Furthermore, the insertion and manipulation of a stiff ML device is often technically challenging during enteroscopy-assisted ERCP.…”

Section: Enteroscopy-assisted Ercpmentioning

confidence: 99%

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Management of Difficult Bile Duct Stones by Large Balloon, Cholangioscopy, Enteroscopy and Endosonography

et al. 2020

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Endoscopic management of bile duct stones is now the standard of care, but challenges remain with difficult bile duct stones. There are some known factors associated with technically difficult bile duct stones, such as large size and surgically altered anatomy. Endoscopic mechanical lithotripsy is now the standard technique used to remove large bile duct stones, but the efficacy of endoscopic papillary large balloon dilatation (EPLBD) and cholangioscopy with intraductal lithotripsy has been increasingly reported. In patients with surgically altered anatomy, biliary access before stone removal can be technically difficult. Endotherapy using two new endoscopes is now utilized in clinical practice: enteroscopyassisted endoscopic retrograde cholangiopancreatography and endoscopic ultrasound-guided antegrade treatment. These new approaches can be combined with EPLBD and/ or cholangioscopy to remove large bile duct stones from patients with surgically altered anatomy. Since various endoscopic procedures are now available, endoscopists should learn the indications, advantages and disadvantages of each technique for better management of bile duct stones.

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Section: Enteroscopy-assisted Ercpmentioning

confidence: 99%

Section: Enteroscopy-assisted Ercpmentioning

confidence: 99%

Management of Difficult Bile Duct Stones by Large Balloon, Cholangioscopy, Enteroscopy and Endosonography

et al. 2020

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“…ERCP was performed using a short-type double-balloon endoscope (EC-450BI5/EI-530B with a 2.8-mm-wide working channel or EI-580BT with a 3.2-mm-wide working channel; Fujifilm, Tokyo, Japan) with CO 2 insufflation. During the study period, EC-450BI5 or EI-530B was initially used and EI-580BT was used since July 2015 [22]. BE-ERCP was performed under moderate sedation with intravenous injection of diazepam or midazolam and pethidine hydrochloride during the procedure, and continuous intravenous administration of dexmedetomidine hydrochloride.…”

Section: Endoscopic Proceduresmentioning

confidence: 99%

Feasibility of balloon endoscope-assisted endoscopic retrograde cholangiopancreatography for the elderly

et al. 2020

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Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) for patients with surgically altered anatomy is challenging. Recently, balloon endoscopy has been shown to facilitate ERCP for this population with a high technical success rate, but adverse events (AEs) are not uncommon. Compared to non-elderly patients, elderly patients may be at higher risk of AEs due to underlying comorbidities. The current study aimed to evaluate the feasibility of balloon endoscope-assisted ERCP (BE-ERCP) for the elderly. Patients and methods We retrospectively identified patients who underwent BE-ERCP between January 2010 and September 2019. For patients who underwent multiple procedures during the study period, the first session was analyzed. Early AEs associated with BE-ERCP were compared between elderly (≥ 75 years) and non-elderly patients. Results A total of 1,363 BE-ERCP procedures were performed, and 568 patients (211 elderly and 357 non-elderly) were included for the analyses. Technical success rates were high in both the elderly and non-elderly groups (80 % vs. 80 %, respectively). The rates of early AEs were similar between the groups (12 % vs. 9.0 % in the elderly and non-elderly group, respectively; P = 0.31). The mltivariable-adjusted odds ratio for early AEs comparing elderly to non-elderly patients was 1.36 (95 % confidence interval, 0.74–2.51; P = 0.32). Specifically, we did not observe between-group differences in rates of gastrointestinal perforation (2.4 % vs. 2.8 % in elderly and non-elderly groups, respectively; P = 0.99) and aspiration pneumonia (1.9 % vs. 0.6 %, P = 0.20). Conclusions BE-ERCP is a feasible procedure for elderly individuals with surgically altered anatomy.

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“…Recently, new short-type therapeutic enteroscopes are commercially available and clinical outcomes of enteroscopeassisted ERCP in patients with surgically altered anatomy have been markedly improved. [32][33][34] In our institution, we utilized enteroscopy-assisted ERCP first and EUS-PD after failed ERCP. 35 A total of 40 cases underwent enteroscopy-assisted ERCP first (n = 38) and EUS-PD first due to severe adhesion from prior surgery (n = 2).…”

Section: Comparison With Ercpmentioning

confidence: 99%

Technical tips for endoscopic ultrasound-guided pancreatic duct access and drainage

Nakai

2020

Int J Gastrointest Interv

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Endoscopic ultrasound (EUS)-guided pancreatic duct access and drainage can be achieved by EUS-guided rendezvous (EUS-RV) or EUS-guided pancreatic duct drainage (EUS-PD) by transmural stent placement. Although the procedure is utilized for further complex treatment such as intraductal lithotripsy in obstructive pancreatic duct stones, the procedure is technically difficult compared to other EUS-guided interventions. Recently, some devices are developed for EUS-guided pancreatic duct intervention. In this review, technical tips are reviewed in a step-by-step fashion from puncture, guidewire insertion, tract dilation to drainage. Given the advantage of EUS-guided approach, treatment algorithm of endotherapy for pancreatic indications should be further established especially in cases with surgically altered anatomy.

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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

Abstract: A new short-type DBE allows faster insertion to the target site for pancreaticobiliary intervention in patients with surgically altered anatomy.

Cited by 34 publications

References 22 publications

Management of Difficult Bile Duct Stones by Large Balloon, Cholangioscopy, Enteroscopy and Endosonography

Management of Difficult Bile Duct Stones by Large Balloon, Cholangioscopy, Enteroscopy and Endosonography

Feasibility of balloon endoscope-assisted endoscopic retrograde cholangiopancreatography for the elderly

Technical tips for endoscopic ultrasound-guided pancreatic duct access and drainage

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