Endoscopic Retrograde Cholangiopancreatography in Patients With Surgically Altered Gastrointestinal Anatomy: A Retrospective Study
| Autor: | Yoshihiro Miyasaka, Kohei Nakata, Yoshitaka Gotoh, Yoshihiro Ogawa, Kenjiro Date, Takao Ohtsuka, Takashi Osoegawa, Kazuhiko Nakamura, Yohei Nakashima, Takaaki Fujimoto, So Nakamura, Yasuhisa Mori, Shuji Shimizu, Eikichi Ihara, Masafumi Nakamura, Akira Aso, Yoshihiko Sadakari |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test business.industry Retrospective cohort study Roux-en-Y anastomosis Surgery 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis medicine 030211 gastroenterology & hepatology In patient Double balloon endoscopy Complication business |
| Zdroj: | International Surgery. 103:184-190 |
| ISSN: | 2520-2456 0020-8868 |
| DOI: | 10.9738/intsurg-d-17-00137.1 |
| Popis: | Objective: The aim of this study was to evaluate the difficulty of endoscopic retrograde cholangiopancreatography (ERCP) procedures when performed in patients with different types of surgically altered gastrointestinal (GI) anatomies. Summary of background data: Clinical data of 102 consecutive patients with surgically altered GI anatomy who underwent ERCP using a double-balloon enteroscope or a regular gastroendoscope between January 2008 and March 2015 were retrospectively reviewed. Methods: The success rate of reaching the destination, the time until reaching the destination, the success rate of the procedures, and complications were assessed for each type of altered GI anatomy using a double-balloon enteroscope and a regular gastroendoscope. Results: A total of 180 ERCP procedures were performed. The total success rate of reaching the destination was 91% (164 of 180), and that of treatment was 88% (144 of 164). The success rate of reaching the destination in patients with Roux-en-Y hepaticojejunostomy (HJ + R-Y) was significantly lower than that of the other types of reconstruction. The time until reaching the destination was significantly longer in patients after R-Y reconstruction (gastrectomy or HJ) than that after Billroth-II gastrectomy or pancreatoduodenectomy. GI perforation occurred in 2 patients after R-Y reconstruction (1 patient after gastrectomy, and 1 patient after HJ). However, no other complications, such as severe pancreatitis, bleeding, or air embolism, were observed. Conclusions: ERCP for patients with surgically altered GI anatomy is feasible. Improvement of the success rate of reaching the destination in patients after HJ + R-Y and prevention of perforation in those with R-Y reconstruction are necessary. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|