Abstract
Background and aims
To investigate the effectiveness of double-balloon enteroscope-assisted retrograde
cholangiopancreatography (DBE-ERCP) in patients with gastrointestinal surgically altered
anatomy (SAA).
Methods
From May 2013 to October 2021, all consecutive patients undergoing DBE-ERCP in three
gastroenterological referral centers in Northern Italy were enrolled in the study.
Patients were assessed regarding their medical history, previous surgery, time from
previous surgery to the DBE-ERCP procedure, and the success or failure of DBE-ERCP.
Results
Fifty-three patients (60% men, median age 65 (23–89) years) undergoing 67 DBE-ERCP
procedures (1–3 DBE-ERCP per patient) were enrolled. Reasons for SAA included orthotopic
liver transplantation (23%), ulcers (15%), malignancies (43%), difficult cholecystectomy
(17%), and other causes (2%). Types of surgery included Roux-en-Y biliodigestive anastomosis
(45%), Roux-en-Y gastrectomy (32%), pancreaticoduodenectomy (17%), and Billroth II
gastrectomy (6%). The overall DBE-ERCP success rate was 86%. The type of surgery,
indications, and the length of time between previous surgery and DBE-ERCP were not
statistically associated with DBE-ERCP success. The DBE-ERCP success rate increased
from 2018 to 2021.
Conclusions
DBE-ERCP is a successful procedure in challenging patients with SAA. The improvement
in results over time indicates the necessity of adequate training and of centralizing
patients in referral centers.
Keywords
Abbreviations:
B2 (Billroth II), DBE (double-balloon endoscopy), ERCP (endoscopic retrograde cholangiopancreatography), OLT (orthotopic liver transplantation), PD (pancreatoduodenectomy), RY (Roux-en-Y), RYGB (Roux-en-Y gastric bypass), RYHJ (Roux-en-Y hepaticojejunostomy), PTBD (percutaneous transhepatic biliary drainage)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: November 12, 2022
Accepted:
October 21,
2022
Received:
July 3,
2022
Publication stage
In Press Corrected ProofFootnotes
Financial support statement: nothing to disclose.
Data availability statement: Data from the present study are confidential but can be provided upon direct request to the authors.
Identification
Copyright
© 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
