Systematic review of transgastric ERCP in Roux-en-Y gastric bypass patients
| Autor: | Nikhil Banerjee, B. Joseph Elmunzer, T. Karl Byrne, Rana Pullatt, Gregory A. Cote, Mayur Parepally |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Endoscopic ultrasound
medicine.medical_specialty medicine.medical_treatment Biliary Tract Diseases Gastric bypass Gastric Bypass digestive system 03 medical and health sciences 0302 clinical medicine Postoperative Complications medicine Humans Adverse effect Gastric Balloon Cholangiopancreatography Endoscopic Retrograde Gastrostomy medicine.diagnostic_test business.industry Stomach General surgery medicine.disease Roux-en-Y anastomosis digestive system diseases Surgery surgical procedures operative medicine.anatomical_structure Treatment Outcome 030220 oncology & carcinogenesis Pancreatitis 030211 gastroenterology & hepatology Observational study Laparoscopy business |
| Zdroj: | Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. 13(7) |
| ISSN: | 1878-7533 |
| Popis: | Balloon-assisted endoscopic retrograde cholangiopancreatoscopy (ERCP) in Roux-en-Y gastric bypass (RYGB) patients is technically challenging due to anatomic and accessory constraints, thus success rates are modest. Transgastric ERCP (TG-ERCP) offers a viable alternative. We aimed to systematically review the literature on TG-ERCP in RYGB patients to better define the technical approaches, success rates, and adverse events of this procedure. A computer-assisted search of the Embase and PubMed databases was performed to identify studies that focused on the techniques and clinical outcomes of TG-ERCP. Two investigators independently identified studies and abstracted relevant data. The literature search yielded 26 eligible studies comprising 509 TG-ERCP cases. Access to the excluded stomach to facilitate ERCP was achieved laparoscopically in 58% of reported cases, via open surgery (6% of reported cases), by antecedent placement of a percutaneous gastrostomy tube (33%), or with endoscopic ultrasound assistance (3%). Successful gastric access was reported in 100% of cases and successful ductal cannulation in 98.5%. Adverse events were reported in 14% of cases; 80% of these were related to gastrostomy creation and the rest were attributable to ERCP. Wound infections (n = 19, 3.7%) were the most common gastrostomy-related adverse event, and post-ERCP pancreatitis (n = 7, 1.4%) was the most common ERCP-related adverse event. No deaths were reported. Based on existing observational studies, TG-ERCP appears to be a safe and highly effective approach in patients with RYGB anatomy. Additional research and clinical experience are needed to more precisely define the risk-benefit ratio and optimal technique of TG-ERCP. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|