Endoscopic retrograde cholangiopancreatography using short‐type double‐balloon enteroscope: Experience in Hong Kong

Autor:	Michael Kin Kong Li, Ka Shing Cheng, Wai Lok Choi, Wai Man Yip, Man Chung Fong
Rok vydání:	2021
Předmět:	Cholangiopancreatography Endoscopic Retrograde Double-Balloon Enteroscopy Enteroscopy medicine.medical_specialty Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test business.industry medicine.medical_treatment Perforation (oil well) Gastroenterology Pancreaticoduodenectomy medicine.disease Roux-en-Y anastomosis Surgery Treatment Outcome Pancreatitis Laparotomy Acute Disease Hong Kong Humans Medicine Acute pancreatitis Gastrectomy business Retrospective Studies
Zdroj:	Journal of Digestive Diseases. 22:545-550
ISSN:	1751-2980 1751-2972
DOI:	10.1111/1751-2980.13040
Popis:	OBJECTIVE To illustrate the efficacy and safety profile of double-balloon enteroscopy (DBE)-assisted endoscopic retrograde cholangiopancreatography (ERCP) using a short enteroscope in patients with surgically altered anatomy. METHODS A retrospective study was performed to review the endoscopic outcomes of patients undergoing DBE-assisted ERCP for biliary diseases in Tuen Mun and Pok Oi hospitals in Hong Kong SAR, China from December 2015 to December 2020. RESULTS Altogether 46 DBE-assisted ERCP procedures were performed in 37 patients. The enteroscopic success rate, defined as reaching the papilla or bilioenteric anastomosis, was 95.7% (95% confidence interval [CI] 85.2%-99.5%), which was significantly lower in patients with intact stomach than in those who had a previous gastrectomy (67% vs 100%, P = 0.014). The diagnostic ERCP success rate, defined as performance in an informative cholangiogram, was 84.1% (95% CI 69.9%-93.4%) in cases where it was attempted. Intended biliary therapeutic interventions were successfully performed in 76.1% (95% CI 61.2%-87.4%) of all procedures. Adverse events were reported in six (13.0%) procedures (95% CI 4.9%-26.3%), including the micro-perforation of the intestine in two (4.3%) patients with prior Roux-en-Y gastrectomy, three (6.5%) of acute cholangitis and one (2.2%) of acute pancreatitis. All adverse events were managed successfully using conservative methods except in one case of micro-perforation, which required a laparotomy. CONCLUSIONS DBE-assisted ERCP using a short enteroscope is a promising technique for managing biliary diseases in patients with surgically altered anatomy. It must be performed to avoid perforation, particularly in patients with a Roux-en-Y reconstruction.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::893c0fbc004b17b70449f046bd633a8d https://doi.org/10.1111/1751-2980.13040 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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