Endoscopy 2017; 49(01): 69-74
DOI: 10.1055/s-0042-118301
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

Short-type single-balloon enteroscope-assisted ERCP in postsurgical altered anatomy: potential factors affecting procedural failure

Kei Yane
1   Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
,
Akio Katanuma
1   Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
,
Hiroyuki Maguchi
1   Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
,
Kuniyuki Takahashi
1   Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
,
Toshifumi Kin
1   Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
,
Satoshi Ikarashi
1   Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
,
Itsuki Sano
1   Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
,
Hajime Yamazaki
1   Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
,
Koh Kitagawa
1   Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
,
Kensuke Yokoyama
1   Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
,
Hideaki Koga
1   Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
,
Kazumasa Nagai
1   Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
,
Masanori Nojima
2   Center for Translational Research, Institute of Medical Science Hospital, University of Tokyo, Tokyo, Japan
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Publikationsverlauf

submitted24. April 2016

accepted after revision08. September 2016

Publikationsdatum:
19. Oktober 2016 (online)

Abstract

Background and study aims Short-type single-balloon enteroscope (short SBE)-assisted endoscopic retrograde cholangiopancreatography (ERCP) is a promising alternative treatment in postsurgical altered anatomy. However, it is technically demanding, and factors affecting its technical difficulty have not yet been clarified. This study aimed to examine the procedural success rate of short SBE-assisted ERCP and the potential factors affecting procedural failure.

Patients and methods A total of 117 consecutive patients (203 procedures) with surgically altered anatomy underwent ERCP using prototype short SBEs. The procedural success rate of short SBE-assisted ERCP and the potential factors affecting procedural failure were examined retrospectively.

Results The enteroscopy success rate and procedural success rate were 92.6 % (95 % confidence interval [CI] 88.1 % – 95.8 %) and 81.8 % (95 %CI 75.8 % – 86.8 %), respectively. Multivariate analyses indicated that pancreatic indication (odds ratio [OR] 4.35, 95 %CI 1.67 – 11.4), first ERCP attempt (OR 6.03, 95 %CI 2.17 – 16.8), and no transparent hood (OR 4.61, 95 %CI 1.48 – 14.3) were potential risk factors for procedural failure.

Conclusions Short SBE-assisted ERCP was effective in postsurgical altered anatomy. This large case series suggested the potential factors affecting procedural failure.

 
  • References

  • 1 Wang AY, Sauer BG, Behm BW. et al. Single-balloon enteroscopy effectively enables diagnostic and therapeutic retrograde cholangiography in patients with surgically altered anatomy. Gastrointest Endosc 2010; 71: 641-649
  • 2 Saleem A, Baron TH, Gostout CJ. et al. Endoscopic retrograde cholangiopancreatography using a single-balloon enteroscope in patients with altered Roux-en-Y anatomy. Endoscopy 2010; 42: 656-660
  • 3 Skinner M, Popa D, Neumann H. et al. ERCP with the overtube-assisted enteroscopy technique: a systematic review. Endoscopy 2014; 46: 560-572
  • 4 Obana T, Fujita N, Ito K. et al. Therapeutic endoscopic retrograde cholangiography using a single-balloon enteroscope in patients with Roux-en-Y anastomosis. Dig Endosc 2013; 25: 601-607
  • 5 Yamauchi H, Kida M, Okuwaki K. et al. Short-type single balloon enteroscope for endoscopic retrograde cholangiopancreatography with altered gastrointestinal anatomy. World J Gastroenterol 2013; 19: 1728-1735
  • 6 Iwai T, Kida M, Yamauchi H. et al. Short-type and conventional single-balloon enteroscopes for endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy: single-center experience. Dig Endosc 2014; 26 (Suppl. 02) 156-163
  • 7 Shimatani M, Takaoka M, Ikeura T. et al. Evaluation of endoscopic retrograde cholangiopancreatography using a newly developed short-type single-balloon endoscope in patients with altered gastrointestinal anatomy. Dig Endosc 2014; 26 (Suppl. 02) 147-155
  • 8 Kawamura T, Uno K, Suzuki A. et al. Clinical usefulness of a short-type, prototype single-balloon enteroscope for endoscopic retrograde cholangiopancreatography in patients with altered gastrointestinal anatomy: preliminary experiences. Dig Endosc 2015; 27: 82-86
  • 9 Yamauchi H, Kida M, Okuwaki K. et al. Passive-bending, short-type single-balloon enteroscope for endoscopic retrograde cholangiopancreatography in Roux-en-Y anastomosis patients. World J Gastroenterol 2015; 21: 1546-1553
  • 10 Cotton PB, Eisen GM, Aabakken L. et al. A lexicon for endoscopic adverse events: report of an ASGE workshop. Gastrointest Endosc 2010; 71: 446-454
  • 11 Kanda Y. Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant 2013; 48: 452-458
  • 12 Inamdar S, Slattery E, Sejpal DV. et al. Systematic review and meta-analysis of single-balloon enteroscopy-assisted ERCP in patients with surgically altered GI anatomy. Gastrointest Endosc 2015; 82: 9-19
  • 13 Shimatani M, Matsushita M, Takaoka M. et al. Effective “short” double-balloon enteroscope for diagnostic and therapeutic ERCP in patients with altered gastrointestinal anatomy: a large case series. Endoscopy 2009; 41: 849-854
  • 14 Kurihara T, Itoi T, Sofuni A. et al. Endoscopic ultrasonography-guided pancreatic duct drainage after failed endoscopic retrograde cholangiopancreatography in patients with malignant and benign pancreatic duct obstructions. Dig Endosc 2013; 25 (Suppl. 02) 109-116
  • 15 Trindade AJ, Mella JM, Slattery E. et al. Use of a cap in single-balloon enteroscopy-assisted endoscopic retrograde cholangiography. Endoscopy 2015; 47: 453-456