Single-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreaticography in patients with surgically altered anatomy: higher failure rate in malignant biliary obstruction – a prospective single center cohort analysis
| Autor: | Wolfram Domschke, Hauke Heinzow, Philipp Matern, Hansjoerg Ullerich, Frank Lenze, Tobias Meister |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Enteroscopy medicine.medical_specialty Gastric Bypass Digestive System Neoplasms Single Center digestive system Endoscopy Gastrointestinal Pancreaticoduodenectomy Young Adult 03 medical and health sciences 0302 clinical medicine Gastrectomy Pancreaticojejunostomy medicine Humans In patient Prospective Studies Aged Aged 80 and over Cholangiopancreatography Endoscopic Retrograde Univariate analysis Cholestasis business.industry Gastroenterology Anastomosis Roux-en-Y Single-Balloon Enteroscopy Anatomy Middle Aged digestive system diseases 3. Good health Surgery Choledocholithiasis Treatment Outcome surgical procedures operative 030220 oncology & carcinogenesis Baseline characteristics Cohort Female 030211 gastroenterology & hepatology Radiology business Cohort study |
| Zdroj: | Scandinavian Journal of Gastroenterology. 49:766-771 |
| ISSN: | 1502-7708 0036-5521 |
| Popis: | The performance of endoscopic retrograde cholangiopancreaticography (ERCP) in patients with post-surgically altered anatomy is technically ambitious. Our study aimed at comparing a cohort of patients having successfully undergone single-balloon enteroscopy (SBE)-assisted ERCP to those in whom SBE-ERCP failed.This trial is a prospective single center cohort study. Participants included 30 patients (median age 69.5 years, range 20-86 years) with previous pancreaticobiliary surgery. First, a conventional ERCP approach was attempted in all patients. Additionally, those patients in whom prior conventional ERCP had failed underwent SBE-ERCP (n = 26). Patients' baseline characteristics were retrieved and patient cohorts with and without successful SBE-ERCPs were compared and analyzed. Statistical analysis was applied. Univariate analysis was performed to detect possible risk factors of SBE-ERCP failure.The overall success rate of SBE-ERCP, including two patients with percutaneous transhepatic cholangiography- assisted rendezvous technique was 65.4% (17/26). Patients with malignant obstructive cholestasis had a significantly higher failure rate compared to those with benign strictures (84.2% vs. 14.2%, p0.001).SBE-ERCP is a promising tool for diagnostic and therapeutic procedures in the pancreaticobiliary system of selected, previously operated patients with failure of conventional ERCP. However, higher failure rates in malignant biliary obstruction should be taken into account. |
| Databáze: | OpenAIRE |
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