Abstract
Background: Short-type double-balloon endoscope (DBE)-assisted endoscopic retrograde cholangiopancreatography (ERCP) has been developed as an alternative approach for cases with a surgically altered gastrointestinal anatomy. However, this technique is sometimes technically challenging and carries a risk of severe adverse events. Aims: To evaluate the factors affecting the technical success rate and adverse events of DBE-ERCP. Methods: A total of 319 patients (805 procedures) with a surgically altered gastrointestinal anatomy underwent short DBE-ERCP. The factors affecting the technical success rate and adverse events, and the learning curve of the trainees were retrospectively evaluated. Results: The technical success rate of all procedures was 90.7%. Adverse events occurred in 44 (5.5%) procedures. A multivariate analysis indicated that Roux-en-Y reconstruction and first-time short DBE-ERCP were factors affecting the technical failure and adverse event rates, while the modified Child method after subtotal stomach-preserving pancreaticoduodenectomy reconstruction was a non-risk factor for adverse events. The trainee caseload did not affect the technical success or adverse event rates significantly; however, trainees tended to perform cases involving the modified Child method after subtotal stomach-preserving pancreaticoduodenectomy reconstruction. The success rate of scope insertion increased according to experience; however, the overall success rate did not differ to a statistically significant extent. Conclusion: Short DBE-ERCP was useful and safe for managing cases with a surgically altered anatomy; however, trainees should concentrate on accumulating experience with easy cases, such as those with the modified Child method after subtotal stomach-preserving pancreaticoduodenectomy reconstruction or a history of DBE-ERCP.
| Original language | English |
|---|---|
| Journal | Digestive Diseases and Sciences |
| DOIs | |
| Publication status | Accepted/In press - Jan 1 2019 |
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Keywords
- Biliary tract diseases
- Double-balloon enteroscopy
- Endoscopic retrograde cholangiopancreatography
- Pancreatic diseases
- Surgically altered anatomy
ASJC Scopus subject areas
- Physiology
- Gastroenterology
Cite this
Potential Factors Affecting Results of Short-Type Double-Balloon Endoscope-Assisted Endoscopic Retrograde Cholangiopancreatography. / Uchida, Daisuke; Tsutsumi, Koichiro; Kato, Hironari; Matsumi, Akihiro; Saragai, Yosuke; Tomoda, Takeshi; Matsumoto, Kazuyuki; Horiguchi, Shigeru; Okada, Hiroyuki.
In: Digestive Diseases and Sciences, 01.01.2019.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Potential Factors Affecting Results of Short-Type Double-Balloon Endoscope-Assisted Endoscopic Retrograde Cholangiopancreatography
AU - Uchida, Daisuke
AU - Tsutsumi, Koichiro
AU - Kato, Hironari
AU - Matsumi, Akihiro
AU - Saragai, Yosuke
AU - Tomoda, Takeshi
AU - Matsumoto, Kazuyuki
AU - Horiguchi, Shigeru
AU - Okada, Hiroyuki
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Background: Short-type double-balloon endoscope (DBE)-assisted endoscopic retrograde cholangiopancreatography (ERCP) has been developed as an alternative approach for cases with a surgically altered gastrointestinal anatomy. However, this technique is sometimes technically challenging and carries a risk of severe adverse events. Aims: To evaluate the factors affecting the technical success rate and adverse events of DBE-ERCP. Methods: A total of 319 patients (805 procedures) with a surgically altered gastrointestinal anatomy underwent short DBE-ERCP. The factors affecting the technical success rate and adverse events, and the learning curve of the trainees were retrospectively evaluated. Results: The technical success rate of all procedures was 90.7%. Adverse events occurred in 44 (5.5%) procedures. A multivariate analysis indicated that Roux-en-Y reconstruction and first-time short DBE-ERCP were factors affecting the technical failure and adverse event rates, while the modified Child method after subtotal stomach-preserving pancreaticoduodenectomy reconstruction was a non-risk factor for adverse events. The trainee caseload did not affect the technical success or adverse event rates significantly; however, trainees tended to perform cases involving the modified Child method after subtotal stomach-preserving pancreaticoduodenectomy reconstruction. The success rate of scope insertion increased according to experience; however, the overall success rate did not differ to a statistically significant extent. Conclusion: Short DBE-ERCP was useful and safe for managing cases with a surgically altered anatomy; however, trainees should concentrate on accumulating experience with easy cases, such as those with the modified Child method after subtotal stomach-preserving pancreaticoduodenectomy reconstruction or a history of DBE-ERCP.
AB - Background: Short-type double-balloon endoscope (DBE)-assisted endoscopic retrograde cholangiopancreatography (ERCP) has been developed as an alternative approach for cases with a surgically altered gastrointestinal anatomy. However, this technique is sometimes technically challenging and carries a risk of severe adverse events. Aims: To evaluate the factors affecting the technical success rate and adverse events of DBE-ERCP. Methods: A total of 319 patients (805 procedures) with a surgically altered gastrointestinal anatomy underwent short DBE-ERCP. The factors affecting the technical success rate and adverse events, and the learning curve of the trainees were retrospectively evaluated. Results: The technical success rate of all procedures was 90.7%. Adverse events occurred in 44 (5.5%) procedures. A multivariate analysis indicated that Roux-en-Y reconstruction and first-time short DBE-ERCP were factors affecting the technical failure and adverse event rates, while the modified Child method after subtotal stomach-preserving pancreaticoduodenectomy reconstruction was a non-risk factor for adverse events. The trainee caseload did not affect the technical success or adverse event rates significantly; however, trainees tended to perform cases involving the modified Child method after subtotal stomach-preserving pancreaticoduodenectomy reconstruction. The success rate of scope insertion increased according to experience; however, the overall success rate did not differ to a statistically significant extent. Conclusion: Short DBE-ERCP was useful and safe for managing cases with a surgically altered anatomy; however, trainees should concentrate on accumulating experience with easy cases, such as those with the modified Child method after subtotal stomach-preserving pancreaticoduodenectomy reconstruction or a history of DBE-ERCP.
KW - Biliary tract diseases
KW - Double-balloon enteroscopy
KW - Endoscopic retrograde cholangiopancreatography
KW - Pancreatic diseases
KW - Surgically altered anatomy
UR - http://www.scopus.com/inward/record.url?scp=85073937534&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85073937534&partnerID=8YFLogxK
U2 - 10.1007/s10620-019-05857-3
DO - 10.1007/s10620-019-05857-3
M3 - Article
C2 - 31562611
AN - SCOPUS:85073937534
JO - American Journal of Digestive Diseases
JF - American Journal of Digestive Diseases
SN - 0002-9211
ER -