Abstract
Background and Aim: Data on long-term outcomes after therapeutic endoscopic retrograde cholangiopancreatography (ERCP) using balloon-assisted enteroscopy (BAE) for choledochojejunal anastomotic stenosis (CJS) or pancreaticojejunal anastomotic stenosis (PJS) remain limited. We retrospectively assessed the long-term results of patients who achieved clinical success using BAE for CJS and PJS. Methods: Patients who achieved technical and clinical success for CJS or PJS by BAE-ERCP and were followed up for more than 6 months after the initial BAE-ERCP therapy were retrospectively identified at 11 Japanese institutions. The primary end-point was CJS or PJS recurrence rates. The secondary end-points were initial therapy details, initial therapy complications, and CJS or PJS recurrence treatment details. We also evaluated restenosis-associated factors. Results: From September 2008 to December 2015, 67 patients (CJS, 61; PJS, six) were included. The overall CJS and PJS recurrence rates were 34.4% and 33.3%, respectively. The 1-year CJS recurrence rate was 18.5% (95% confidence interval, 10.7–31.0). Of all the patients, 88.1% underwent balloon dilation at the anastomotic stenosis site; stent placement was performed in 15 of 67 patients (22.4%). The complication rate was 8.2% in CJS and 0% in PJS. In patients who underwent balloon dilation, “remaining waist” was significantly associated with CJS recurrence after anastomotic balloon dilation (P = 0.001). Conclusions: The long-term outcomes of BAE-ERCP were comparable with those of percutaneous transhepatic treatment or surgical re-anastomosis.
| Original language | English |
|---|---|
| Pages (from-to) | 612-619 |
| Number of pages | 8 |
| Journal | Journal of Gastroenterology and Hepatology (Australia) |
| Volume | 34 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 1 2019 |
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Keywords
- anastomotic stenosis
- balloon-assisted endoscopy
- choledochojejunostomy
- ERCP
- pancreaticojejunostomy
ASJC Scopus subject areas
- Hepatology
- Gastroenterology
Cite this
Long-term outcomes after therapeutic endoscopic retrograde cholangiopancreatography using balloon-assisted enteroscopy for anastomotic stenosis of choledochojejunostomy/pancreaticojejunostomy. / Sano, Itsuki; Katanuma, Akio; Kuwatani, Masaki; Kawakami, Hiroshi; Katou, Hironari; Itoi, Takao; Ono, Michihiro; Irisawa, Atsushi; Okabe, Yoshinobu; Iwashita, Takuji; Yasuda, Ichiro; Ryozawa, Shomei; Kaino, Seiji; Sakamoto, Naoya.
In: Journal of Gastroenterology and Hepatology (Australia), Vol. 34, No. 3, 01.03.2019, p. 612-619.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Long-term outcomes after therapeutic endoscopic retrograde cholangiopancreatography using balloon-assisted enteroscopy for anastomotic stenosis of choledochojejunostomy/pancreaticojejunostomy
AU - Sano, Itsuki
AU - Katanuma, Akio
AU - Kuwatani, Masaki
AU - Kawakami, Hiroshi
AU - Katou, Hironari
AU - Itoi, Takao
AU - Ono, Michihiro
AU - Irisawa, Atsushi
AU - Okabe, Yoshinobu
AU - Iwashita, Takuji
AU - Yasuda, Ichiro
AU - Ryozawa, Shomei
AU - Kaino, Seiji
AU - Sakamoto, Naoya
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Background and Aim: Data on long-term outcomes after therapeutic endoscopic retrograde cholangiopancreatography (ERCP) using balloon-assisted enteroscopy (BAE) for choledochojejunal anastomotic stenosis (CJS) or pancreaticojejunal anastomotic stenosis (PJS) remain limited. We retrospectively assessed the long-term results of patients who achieved clinical success using BAE for CJS and PJS. Methods: Patients who achieved technical and clinical success for CJS or PJS by BAE-ERCP and were followed up for more than 6 months after the initial BAE-ERCP therapy were retrospectively identified at 11 Japanese institutions. The primary end-point was CJS or PJS recurrence rates. The secondary end-points were initial therapy details, initial therapy complications, and CJS or PJS recurrence treatment details. We also evaluated restenosis-associated factors. Results: From September 2008 to December 2015, 67 patients (CJS, 61; PJS, six) were included. The overall CJS and PJS recurrence rates were 34.4% and 33.3%, respectively. The 1-year CJS recurrence rate was 18.5% (95% confidence interval, 10.7–31.0). Of all the patients, 88.1% underwent balloon dilation at the anastomotic stenosis site; stent placement was performed in 15 of 67 patients (22.4%). The complication rate was 8.2% in CJS and 0% in PJS. In patients who underwent balloon dilation, “remaining waist” was significantly associated with CJS recurrence after anastomotic balloon dilation (P = 0.001). Conclusions: The long-term outcomes of BAE-ERCP were comparable with those of percutaneous transhepatic treatment or surgical re-anastomosis.
AB - Background and Aim: Data on long-term outcomes after therapeutic endoscopic retrograde cholangiopancreatography (ERCP) using balloon-assisted enteroscopy (BAE) for choledochojejunal anastomotic stenosis (CJS) or pancreaticojejunal anastomotic stenosis (PJS) remain limited. We retrospectively assessed the long-term results of patients who achieved clinical success using BAE for CJS and PJS. Methods: Patients who achieved technical and clinical success for CJS or PJS by BAE-ERCP and were followed up for more than 6 months after the initial BAE-ERCP therapy were retrospectively identified at 11 Japanese institutions. The primary end-point was CJS or PJS recurrence rates. The secondary end-points were initial therapy details, initial therapy complications, and CJS or PJS recurrence treatment details. We also evaluated restenosis-associated factors. Results: From September 2008 to December 2015, 67 patients (CJS, 61; PJS, six) were included. The overall CJS and PJS recurrence rates were 34.4% and 33.3%, respectively. The 1-year CJS recurrence rate was 18.5% (95% confidence interval, 10.7–31.0). Of all the patients, 88.1% underwent balloon dilation at the anastomotic stenosis site; stent placement was performed in 15 of 67 patients (22.4%). The complication rate was 8.2% in CJS and 0% in PJS. In patients who underwent balloon dilation, “remaining waist” was significantly associated with CJS recurrence after anastomotic balloon dilation (P = 0.001). Conclusions: The long-term outcomes of BAE-ERCP were comparable with those of percutaneous transhepatic treatment or surgical re-anastomosis.
KW - anastomotic stenosis
KW - balloon-assisted endoscopy
KW - choledochojejunostomy
KW - ERCP
KW - pancreaticojejunostomy
UR - http://www.scopus.com/inward/record.url?scp=85062239590&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85062239590&partnerID=8YFLogxK
U2 - 10.1111/jgh.14605
DO - 10.1111/jgh.14605
M3 - Article
C2 - 30650206
AN - SCOPUS:85062239590
VL - 34
SP - 612
EP - 619
JO - Journal of Gastroenterology and Hepatology (Australia)
JF - Journal of Gastroenterology and Hepatology (Australia)
SN - 0815-9319
IS - 3
ER -