ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP): ANALYSIS OF THE EFFECTIVENESS AND SAFETY OF THE PROCEDURE IN THE PATIENT WITH ROUX-EN-Y GASTRIC BYPASS.

Autor:	Ivano FH; Pontificate Catholic University of Paraná, Medicine.; Service of Digestive Endoscopy, Sugisawa Hospital, Curitiba, PR, Brasil., Ponte BJ; Pontificate Catholic University of Paraná, Medicine., Dubik TC; Pontificate Catholic University of Paraná, Medicine., Ivano VK; Pontificate Catholic University of Paraná, Medicine., Winkeler VLL; Pontificate Catholic University of Paraná, Medicine., Kay AK; Pontificate Catholic University of Paraná, Medicine.; Service of Digestive Endoscopy, Sugisawa Hospital, Curitiba, PR, Brasil.
Jazyk:	English; Portuguese
Zdroj:	Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery [Arq Bras Cir Dig] 2019; Vol. 32 (2), pp. e1432. Date of Electronic Publication: 2019 Apr 29.
DOI:	10.1590/0102-672020190001e1432
Abstrakt:	Background: Obesity can be treated with bariatric surgery; but, excessive weight loss may lead to diseases of the bile duct such as cholelithiasis and choledocholithiasis. Endoscopic retrograde cholangiopancreatography is a diagnostic and therapeutic procedure for these conditions, and may be hampered by the anatomical changes after surgery. Aim: Report the efficacy and the safety of videolaparoscopy-assisted endoscopic retrograde cholangiopancreatography technique in patients after bariatric surgery with Roux-en-Y gastric bypass. Method: Retrospective study performed between 2007 and 2017. Data collected were: age, gender, surgical indication, length of hospital stay, etiological diagnosis, rate of therapeutic success, intra and postoperative complications. Results: Seven patients had choledocholithiasis confirmed by image exam, mainly in women. The interval between gastric bypass and endoscopic procedure ranged from 1 to 144 months. There were no intraoperative complications. The rate of duodenal papillary cannulation was 100%. Regarding complications, the majority of cases were related to gastrostomy, and rarely to endoscopic procedure. There were two postoperative complications, a case of chest-abdominal pain refractory to high doses of morphine on the same day of the procedure, and a laboratory diagnosis of acute pancreatitis after the procedure in an asymptomatic patient. The maximum hospital stay was four days. Conclusion: The experience with endoscopic retrograde cholangiopancreatography through laparoscopic gastrostomy is a safe and effective procedure, since most complications are related to the it and did not altered the sequence to perform the conventional cholangiopancreatography.
Databáze:	MEDLINE
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