Application of single balloon enteroscopy-assisted therapeutic endoscopic retrograde cholangiopancreatography in patients after bilioenteric Roux-en-Y anastomosis: Experience of multi-disciplinary collaboration

World J Gastroenterol. 2019 Sep 28;25(36):5505-5514. doi: 10.3748/wjg.v25.i36.5505.

Abstract

Background: Bilioenteric Roux-en-Y anastomosis is one of the most complicated approaches for reconstructing the gastrointestinal tract, and endoscopic retrograde cholangiopancreatography (ERCP) is technically challenging in patients after bilioenteric Roux-en-Y anastomosis. The optimal endoscopic strategies for such cases remain unknown.

Aim: To explore the feasibility and effectiveness of single balloon enteroscopy-assisted (SBE-assisted) therapeutic ERCP in patients after bilioenteric Roux-en-Y anastomosis based on multi-disciplinary collaboration between endoscopists and surgeons as well as report the experience from China.

Methods: This is a single center retrospective study. All of the SBE-assisted therapeutic ERCP procedures were performed by the collaboration between endoscopists and surgeons. The operation time, success rate, and complication rate were calculated.

Results: Forty-six patients received a total of 64 SBE-assisted therapeutic ERCP procedures, with successful scope intubation in 60 (93.8%) cases and successful diagnosis in 59 (92.2%). All successfully diagnosed cases received successful therapy. None of the cases had perforation or bleeding during or after operation, and no post-ERCP pancreatitis occurred.

Conclusion: Based on multi-disciplinary collaboration, SBE-assisted therapeutic ERCP in patients after bilioenteric Roux-en-Y anastomosis is relatively safe and effective and has a high success rate.

Keywords: Bilioenteric Roux-en-Y anastomosis; Hepaticojejunostomy; Multi-disciplinary cooperation; Pancreaticoduodenectomy; Single balloon enteroscopy.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anastomosis, Roux-en-Y / adverse effects*
  • Biliary Tract Diseases / surgery*
  • China / epidemiology
  • Cholangiopancreatography, Endoscopic Retrograde / adverse effects
  • Cholangiopancreatography, Endoscopic Retrograde / methods*
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Operative Time
  • Pancreatic Diseases / surgery*
  • Patient Care Team
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Reoperation / adverse effects
  • Reoperation / methods*
  • Retrospective Studies
  • Single-Balloon Enteroscopy / adverse effects
  • Single-Balloon Enteroscopy / methods*