scholarly journals Adverse events of balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy

2018 ◽  
Vol 92 (1) ◽  
pp. 64-68
Author(s):  
Kunihiro Hosono ◽  
Kensuke Kubota ◽  
Akito Iwasaki ◽  
Takamitsu Sato ◽  
Emiko Tanida ◽  
...  
Keyword(s):  
Adverse Events ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Endoscopic Retrograde ◽  
Balloon Enteroscopy ◽  
Surgically Altered Anatomy

scholarly journals Risk factors for adverse events associated with endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaojia Chen ◽  
Fan Wang ◽  
Jing Liu ◽  
Wenhui Tao ◽  
Zhang Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bile Duct ◽  
Adverse Events ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Univariate Analysis ◽  
Balloon Dilation ◽  
Endoscopic Papillary Balloon Dilation ◽  
Endoscopic Retrograde ◽  
Therapeutic Success ◽  
Surgically Altered Anatomy

Abstract Introduction Endoscopic retrograde cholangiopancreatography (ERCP) is considered to be a challenge in patients with surgically altered anatomy. We aimed to identify the risk factors of ERCP-related adverse events in patients with surgically altered anatomy in our center. Methods We included patients with surgically altered anatomy who underwent ERCP between April 2017 and December 2020 at our center. Clinical characteristics and outcomes were analyzed in univariate and multivariate methods to identify the risk factors for adverse events. Results A total of 121 ERCP procedures were performed in 93 patients. The papilla or surgical anastomosis was successfully reached in 113 cases (93.4%). Diagnostic success was achieved in 106 cases (93.8%) and subsequent therapeutic success was achieved in 102 cases (96.2%). ERCP-related adverse events occurred in 31 cases (25.6%). In univariate analysis, not first time ERCP attempt, a CBD stone diameter ≥ 15 mm, multiple cannulation attempts, endoscopic papillary balloon dilation, endoscopic papillary large balloon dilation, endoscopic retrograde biliary drainage, biopsy in the bile duct or papilla, mechanical lithotripsy use, and stone retrieval basket were associated with ERCP-related adverse events. In multivariate analysis, multiple cannulation attempts (OR 5.283; 95% CI 1.088–25.659; p = 0.039), endoscopic papillary balloon dilation (OR 4.381; 95% CI 1.191–16.114; p = 0.026), and biopsy in the bile duct or papilla (OR 35.432; 95% CI 2.693–466.104; p = 0.007) were independently associated with ERCP-related adverse events. Conclusions ERCP in patients with surgically altered anatomy was feasible and safe. Interventions including multiple cannulation attempts, endoscopic papillary balloon dilation, and biopsy in the bile duct or papilla were independent risk factors for ERCP-related adverse events.

scholarly journals Single Balloon Enteroscopy-Guided Endoscopic Retrograde Cholangiopancreatography in Surgically Altered Anatomy: Long vs. Short Type

2021 ◽  
Vol 26 (3) ◽  
pp. 181-185
Author(s):  
Chang-Hwan Park
Keyword(s):  
High Risk ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Clinical Studies ◽  
Endoscopic Retrograde ◽  
Balloon Enteroscopy ◽  
Surgically Altered Anatomy ◽  
Single Balloon ◽  
Single Balloon Enteroscopy ◽  
Foregone Conclusion ◽  
Short Type

Traditionally, enteroscopy-guided endoscopic retrograde cholangiopancreatography (ERCP) was considered as troublesome procedure with high risk of complications in patients with surgically altered anatomy (SAA). However, recent studies have suggested that it might not have to be a foregone conclusion. In addition, various enteroscopes have been used for enteroscopy-guided ERCP in patients with SAA showing promising results. Among them, long type single balloon enteroscopes (SBE) have mostly been used for enteroscopy-guided ERCP in Korea. Recently, short type SBE can come in handy all around. Two major points should be considered when to choose between long type and short type SBE in SAA. First, it is the figurative difference between the two types of SBE that effects on actual results of enteroscopy-guided ERCP. Second, it is clinical studies using short type and/or long type SBE for enteroscopy-guided ERCP in patients with SAA. Conclusively speaking, short type SBE should be considered at first for enteroscopy-guided ERCP in most patients with SAA.

scholarly journals Factors Affecting Technical Difficulty in Balloon Enteroscopy-Assisted Endoscopic Retrograde Cholangiopancreatography in Patients with Surgically Altered Anatomy

2021 ◽  
Vol 10 (5) ◽  
pp. 1100
Author(s):  
Naoya Izawa ◽  
Kohei Tsuchida ◽  
Keiichi Tominaga ◽  
Koh Fukushi ◽  
Fumi Sakuma ◽  
...  
Keyword(s):  
Adverse Events ◽  
Success Rate ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Odds Ratio ◽  
Intestinal Tract ◽  
Partial Gastrectomy ◽  
Endoscopic Retrograde ◽  
Balloon Enteroscopy ◽  
Factors Associated ◽  
Younger Age

Success rates of balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (BE-ERCP) for patients with a reconstructed intestinal tract after surgical procedures are unsatisfactory. We retrospectively investigated the factors associated with unsuccessful BE-ERCP. Ninety-one patients who had a reconstructed intestinal tract after gastrectomy or choledochojejunostomy were enrolled. Age, sex, operative method, malignancy, endoscope type, endoscopist’s skill, emergency procedure, and time required to reach the papilla/anastomosis were examined. The primary endpoints were the factors associated with unsuccessful BE-ERCP selective cannulation, while the secondary endpoints were the rate of reaching the papilla/anastomosis, causes of failure to reach the papilla/anastomosis, cannulation success rate, procedure success rate, and rate of adverse events. Younger age (odds ratio, 0.832; 95% CI, 0.706–0.982; p = 0.001) and Roux-en-Y partial gastrectomy (odds ratio, 54.9; 95% CI, 1.09–2763; p = 0.045) were associated with unsuccessful BE- ERCP. The rate of reaching the papilla/anastomosis was 92.3%, the success rate of biliary duct cannulation was 90.5%, procedure success rate was 78.0%, and the rate of adverse events was 5.6%. In conclusion, Roux-en-Y partial gastrectomy and younger age were associated with unsuccessful BE-ERCP. If BE-ERCP is extremely difficult to perform in such patients after Roux-en-Y partial gastrectomy, alternative procedures should be considered early.

scholarly journals Risk Factors for Adverse Events Associated With Endoscopic Retrograde Cholangiopancreatography in Patients With Surgically Altered Anatomy: A Retrospective Study

2021 ◽  
Author(s):  
Xiaojia Chen ◽  
Fan Wang ◽  
Jing Liu ◽  
Zhang Zhang ◽  
Tingting Cao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bile Duct ◽  
Adverse Events ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Univariate Analysis ◽  
Balloon Dilation ◽  
Endoscopic Papillary Balloon Dilation ◽  
Endoscopic Retrograde ◽  
Therapeutic Success ◽  
Surgically Altered Anatomy

Abstract Introduction : Endoscopic retrograde cholangiopancreatography (ERCP) is considered to be a challenge in patients with surgically altered anatomy. We aimed to identify the risk factors of ERCP-related adverse events in patients with surgically altered anatomy in our center. Methods We included patients with surgically altered anatomy who underwent ERCP between April 2017 and December 2020 at our center. Clinical characteristics and outcomes were analyzed in univariate and multivariate methods to identify the risk factors for adverse events. Results A total of 121 ERCP procedures were performed in 93 patients. The papilla or surgical anastomosis was successfully reached in 113 cases (93.4%). Diagnostic success was achieved in 106 cases (93.8%) and subsequent therapeutic success was achieved in 102 cases (96.2%). ERCP-related adverse events occurred in 31 cases (25.6%). In univariate analysis, not first time ERCP attempt, a CBD stone diameter ≥ 15 mm, multiple cannulation attempts, endoscopic papillary balloon dilation, endoscopic papillary large balloon dilation, endoscopic retrograde biliary drainage, biopsy in the bile duct or papilla, mechanical lithotripsy use, and stone retrieval basket were associated with ERCP-related adverse events. In multivariate analysis, multiple cannulation attempts (OR 5.283; 95% CI, 1.088–25.659; p = 0.039), endoscopic papillary balloon dilation (OR 4.381; 95% CI, 1.191–16.114; p = 0.026), and biopsy in the bile duct or papilla (OR 35.432; 95% CI, 2.693-466.104; p = 0.007) were independently associated with ERCP-related adverse events. Conclusions ERCP in patients with surgically altered anatomy was feasible and safe. Interventions including multiple cannulation attempts, endoscopic papillary balloon dilation, and biopsy in the bile duct or papilla were independent risk factors for ERCP-related adverse events.

Underwater cap-assisted Endoscopic Retrograde Cholangiopancreatography in patients with surgically altered anatomy: a pilot study

Endoscopy ◽  
2020 ◽  
Author(s):  
Alessandro Fugazza ◽  
Andrea Anderloni ◽  
Danilo Paduano ◽  
Matteo Badalamenti ◽  
Roberta Maselli ◽  
...  
Keyword(s):  
Bile Duct ◽  
Adverse Events ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Endoscopic Management ◽  
Biliary Disease ◽  
Bile Duct Stones ◽  
Endoscopic Retrograde ◽  
Promising Alternative ◽  
Surgically Altered Anatomy ◽  
Transparent Cap

Introduction Endoscopic retrograde cholangiopancreatography (ERCP) in surgically altered anatomy (SAA) pa-tients is technically challenging and associated with a significant number of failures. We examined the feasibility and efficacy of a novel technique for management of jaundice orcholangitis second-ary to bile duct stones (BDS), called underwater cap-assisted ERCP (u-ERCP). Methods Between June 2019 and February 2020 all patients with jaundice or cholangitis secondary to bile duct stones (BDS) with SAA who underwent u-ERCP were enrolled. The u-ERCP tecnnique combines the underwater advancement of a pediatric colonoscope with a transparent cap fitted on the tip of the endoscope. We evaluated the technical success, clinical suc-cess and adverse events associated with u-ERCP. Results We describe the technique itself and our first experience in 6 patients. A complete and successful procedure was carried out in all patients with no adverse events occurrence. None of the patients needed additional treatments for recurrence of symptoms during the follow-up period. Conclusions The u-ERCP can be considered as a promising alternative for successful endoscopic management of biliary disease in patients with SAA.

Efficacy of an Oxycodone-Propofol Combination versus a Fentanyl-Propofol Combination in Conscious Sedation during Therapeutic Endoscopic Retrograde Cholangiopancreatography in Elderly Patients

Gerontology ◽  
2020 ◽  
pp. 1-8
Author(s):  
Peipei Guo ◽  
Huisheng Wu ◽  
Lan Liu ◽  
Qiu Zhao ◽  
Zhao Jin
Keyword(s):  
Adverse Events ◽  
Elderly Patients ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Postoperative Nausea ◽  
Recovery Time ◽  
Adverse Reactions ◽  
Conscious Sedation ◽  
Endoscopic Retrograde ◽  
Patients Satisfaction ◽  
Low Incidence

<b><i>Background:</i></b> With a rapidly aging population, the need for endoscopic retrograde cholangiopancreatography (ERCP) is increasing. The commonly used sedation anesthesia in ERCP is a combination of propofol and fentanyl, even though fentanyl may cause some adverse reactions such as respiratory depression. <b><i>Objectives:</i></b> This study aimed to evaluate the efficacy of oxycodone combined with propofol versus fentanyl combined with propofol for sedation anesthesia during ERCP. <b><i>Methods:</i></b> A total of 193 patients aged from 65 to 80 years undergoing ERCP were enrolled and randomized into two groups: an “oxycodone combined with propofol” group (group OP, <i>n</i> = 97) and a “fentanyl combined with propofol” group (group FP, <i>n</i> = 96). The rate of perioperative adverse events as well as the recovery time, patients’ satisfaction, and endoscopists’ satisfaction were noted. <b><i>Results:</i></b> There was no difference in the frequency of hypotension or bradycardia between the two groups, but there were more episodes of desaturation (SpO<sub>2</sub> &#x3c;90% for &#x3e;10 s in 8.3%), postoperative nausea (7.3%), and vomiting (5.2%) in group FP than in group OP. Patients’ satisfaction in group FP was lower than that in group OP. The recovery time was longer in group FP than in group OP. <b><i>Conclusions:</i></b> Oxycodone combined with propofol was effective in ERCP, with a low incidence of perioperative adverse events.

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