Biliary Cannulation in Patients with Roux-en-Y Gastrectomy: An Analysis of the Factors Associated with Successful Cannulation
| Autor: | Masahiro Suzuki, Akashi Fujita, Tomoya Ogawa, Yuki Tanisaka, Masafumi Mizuide, Maiko Harada, Ryuichiro Araki, Tatsuya Noguchi, Shomei Ryozawa |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Balloon Enteroscopy endoscopic retrograde cholangiopancreatography medicine.medical_treatment retroflex position Catheterization Gastrectomy Internal Medicine medicine Humans In patient Biliary Tract Aged Retrospective Studies Aged 80 and over Cholangiopancreatography Endoscopic Retrograde Pancreatic duct Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test business.industry Normal anatomy Pancreatic Ducts Anastomosis Roux-en-Y General Medicine Odds ratio Middle Aged Roux-en-Y anastomosis Surgery Major duodenal papilla factors associated with cannulation success medicine.anatomical_structure surgically altered gastrointestinal anatomy Practice Guidelines as Topic Female Original Article business short-type single-balloon enteroscope |
| Zdroj: | Internal Medicine |
| ISSN: | 1349-7235 0918-2918 |
| DOI: | 10.2169/internalmedicine.4245-19 |
| Popis: | Objective We investigated the results of biliary cannulation using a short-type single-balloon enteroscope in patients with a native papilla who had previously undergone Roux-en-Y gastrectomy and analyzed the factors associated with successful cannulation. Methods The study subjects consisted of patients with a native papilla who had previously undergone Roux-en-Y gastrectomy and endoscopic retrograde cholangiopancreatography using a short-type single-balloon enteroscope at our institution between September 2011 and July 2019. We carried out a retrospective investigation of the outcomes, including assessing the success rate of biliary cannulation, and analyzed the factors associated with successful cannulation. Results In total, 78 patients underwent biliary cannulation of a native papilla. The success rate of biliary cannulation was 80.8% (88.5% when including success on repeated attempts). The success rate of the standard cannulation technique was 60.3%, with the use of advanced cannulation techniques to secure the pancreatic duct providing the same additional effect as a normal anatomy. Adverse events occurred in 9.0% of cases. A multivariate analysis of the Roux-en-Y gastrectomy patients found that cannulation was more likely to be successful in patients in whom the scope could be placed in the retroflex position (odds ratio: 7.88, 95% confidence interval: 2.19-37.77, p＜0.001). Conclusion Selective biliary cannulation using a short-type single-balloon enteroscope in patients with a native papilla who had undergone Roux-en-Y gastrectomy was effective and safe. The retroflex position provided a good papilla field of view and improved the success rate of biliary cannulation. |
| Databáze: | OpenAIRE |
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