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CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(02): E163-E171
DOI: 10.1055/a-1067-4411
Original article
Owner and Copyright © Georg Thieme Verlag KG 2020

EDGE in Roux-en-Y gastric bypass: How does it compare to laparoscopy-assisted and balloon enteroscopy ERCP: a systematic review and meta-analysis

Banreet Singh Dhindsa
1   University of Nevada Las Vegas School of Medicine, Las Vegas, Nevada, United States
,
Amaninder Dhaliwal
2   Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, United States
,
Babu P. Mohan
3   Banner University Medical Center, University of Arizona, Tucson, Arizona, United States
,
Harmeet Singh Mashiana
2   Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, United States
,
Mohit Girotra
4   Division of Gastroenterology and Hepatology, University of Miami Miller School of Medicine, Miami, Florida, United States
,
Shailender Singh
2   Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, United States
,
Gordon Ohning
5   Division of Gastroenterology, University of Nevada Las Vegas School of Medicine, Las Vegas, Nevada, United States
,
Ishfaq Bhat
2   Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, United States
,
Douglas G. Adler
6   Department of Gastroenterology and Hepatology, University of Utah School of Medicine, Salt Lake City, Utah
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Publikationsverlauf

submitted 30. Juli 2019

accepted after revision 15. Oktober 2019

Publikationsdatum:
22. Januar 2020 (online)

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Abstract

Background and study aims Endoscopic ultrasound-directed transgastric ERCP (EDGE) is a new endoscopic procedure to perform ERCP in Roux-en-y gastric bypass (RYGB) patients. The aim of this study was to conduct a systematic review and meta-analysis to evaluate technical success, clinical success and adverse effects of EDGE and compare it to laparoscopic ERCP (LA-ERCP) and balloon ERCP (BE-ERCP).

Patients and methods We conducted a comprehensive search of several databases and conference proceedings including PubMed, EMBASE, Google-Scholar, LILACS, SCOPUS, and Web of Science databases to identify studies reporting on EDGE, LA-ERCP, and BE-ERCP. The primary outcome was to evaluate technical and clinical success of all three procedures and the secondary analysis focused on calculating the pooled rate of all adverse events (AEs), along with the commonly reported AE subtypes.

Results Twenty-four studies on 1268 patients were included in our analysis with the majority of the population being males with mean age 53.72 years. Pooled rates of technical and clinical success with EDGE wer 95.5 % and 95.9 %, with LA-ERCP were 95.3 % and 92.9 % and were BE-ERCP were 71.4 % and 58.7 %, respectively. Pooled rates of all AEs with EDGE were 21.9 %, with LA-ERCP 17.4 % and with BE-ERCP 8.4 %. Stent migration was the most common AE with EDGE with 13.3 % followed by bleeding with 6.6 %.

Conclusion Our meta-analysis demonstrated that the technical and clinical success of EDGE procedure is better than BE-ERCP and comparable to that of LA-ERCP in RYGB patients. EDGE also has a similar safety profile as compared to LA-ERCP but has higher AE rate as compared to BE-ERCP.

Supplementary material

 

  • References

  • 1 Ogden CL, Carroll MD, Kit BK. et al. Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA 2014; 311: 806-814
    CrossrefPubMedGoogle Scholar
  • 2 Mechanick JI, Youdim A, Jones DB. et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient -- 2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity 2013; 21 (Suppl. 01) S1-27
    PubMedGoogle Scholar
  • 3 Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg 2013; 23: 427-436
    CrossrefPubMedGoogle Scholar
  • 4 Angrisani L, Santonicola A, Iovino P. et al. IFSO Worldwide Survey 2016: Primary, Endoluminal, and Revisional Procedures. Obes Surg 2018; 28: 3783-3794
    CrossrefPubMedGoogle Scholar
  • 5 Byrne TK. Complications of surgery for obesity. Surg Clin North Am 2001; 81: 1181-1193, vii-viii
    CrossrefPubMedGoogle Scholar
  • 6 Villegas L, Schneider B, Provost D. et al. Is routine cholecystectomy required during laparoscopic gastric bypass?. Obes Surg 2004; 14: 206-211
    CrossrefPubMedGoogle Scholar
  • 7 Calle EE, Rodriguez C, Walker-Thurmond K. et al. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 2003; 348: 1625-1638
    CrossrefPubMedGoogle Scholar
  • 8 Wang TJ, Ryou M. Evolving techniques for endoscopic retrograde cholangiopancreatography in gastric bypass patients. Curr Opin Gastroenterol 2018; 34: 444-450
    CrossrefPubMedGoogle Scholar
  • 9 Ross AS. Techniques for performing ERCP in Roux-en-Y gastric bypass patients. Gastroenterol Hepatol (NY) 2012; 8: 390-392
    PubMedGoogle Scholar
  • 10 da Ponte-Neto AM, Bernardo WM, de Coutinho ALM. et al. Comparison between enteroscopy-based and laparoscopy-assisted ERCP for accessing the biliary tree in patients with roux-en-y gastric bypass: systematic review and meta-analysis. Obes Surg 2018; 28: 4064-4076
    CrossrefPubMedGoogle Scholar
  • 11 Abbas AM, Strong AT, Diehl DL. et al. Multicenter evaluation of the clinical utility of laparoscopy-assisted ERCP in patients with Roux-en-Y gastric bypass. Gastrointest Endosc 2018; 87: 1031-1039
    CrossrefPubMedGoogle Scholar
  • 12 Banerjee N, Parepally M, Byrne TK. et al. Systematic review of transgastric ERCP in Roux-en-Y gastric bypass patients. Surg Obes Relat Dis 2017; 13: 1236-1242
    CrossrefPubMedGoogle Scholar
  • 13 Kedia P, Sharaiha RZ, Kumta NA. et al. Internal EUS-directed transgastric ERCP (EDGE): game over. Gastroenterology 2014; 147: 566-568
    CrossrefPubMedGoogle Scholar
  • 14 Bukhari M, Kowalski T, Nieto J. et al. An international, multicenter, comparative trial of EUS-guided gastrogastrostomy-assisted ERCP versus enteroscopy-assisted ERCP in patients with Roux-en-Y gastric bypass anatomy. Gastrointest Endosc 2018; 88: 486-494
    CrossrefPubMedGoogle Scholar
  • 15 Chiang AL, Gaidhane M, Loren DE. et al. 338 Impact of EUS-directed transgastric ercp (edge procedure) access route on technical success and adverse events: a multi-center experience. Gastrointest Endosc 2018; 87: AB70-AB71
    CrossrefPubMedGoogle Scholar
  • 16 James TW, Baron TH. Endoscopic ultrasound-directed transgastric ERCP (EDGE): a single-center us experience with follow-up data on fistula closure. Obes Surg 2019; 29: 451-456
    CrossrefPubMedGoogle Scholar
  • 17 Wang TJ, Thompson CC, Ryou M. Gastric access temporary for endoscopy (GATE): a proposed algorithm for EUS-directed transgastric ERCP in gastric bypass patients. Surg Endosc 2019; 33: 2024-2033
    CrossrefPubMedGoogle Scholar
  • 18 Moher D, Liberati A, Tetzlaff J. et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 2009; 151: 264-269
    PubMedGoogle Scholar
  • 19 Stroup DF, Berlin JA, Morton SC. et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 2000; 283: 2008-2012
    CrossrefPubMedGoogle Scholar
  • 20 Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 2010; 25: 603-605
    CrossrefPubMedGoogle Scholar
  • 21 Cotton PB, Eisen GM, Aabakken L. et al. A lexicon for endoscopic adverse events: report of an ASGE workshop. Gastrointest Endosc 2010; 71: 446-454
    CrossrefPubMedGoogle Scholar
  • 22 DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials 1986; 7: 177-188
    CrossrefPubMedGoogle Scholar
  • 23 Sutton AJ, Abrams KR, Jones DR. et al. Methods for meta-analysis in medical research. Wiley Chichester; 2000
    Google Scholar
  • 24 Higgins JPT, Thompson SG, Deeks JJ. et al. Measuring inconsistency in meta-analyses. BMJ 2003; 327: 557-560
    CrossrefPubMedGoogle Scholar
  • 25 Kanwal F, White D. Systematic reviews and meta-analyses in clinical gastroenterology and hepatology. Clin Gastroenterol Hepat 2012; 10: 1184-1186
    PubMedGoogle Scholar
  • 26 Guyatt GH, Oxman AD, Kunz R. et al. GRADE guidelines: 7. Rating the quality of evidence–inconsistency. J Clin Epidem 2011; 64: 1294-1302
    CrossrefPubMedGoogle Scholar
  • 27 Easterbrook PJ, Gopalan R, Berlin JA. et al. Publication bias in clinical research. Lancet 1991; 337: 867-872
    CrossrefPubMedGoogle Scholar
  • 28 Duval S, Tweedie R. Trim and fill: a simple funnel‐plot–based method of testing and adjusting for publication bias in meta‐analysis. Biometrics 2000; 56: 455-463
    CrossrefPubMedGoogle Scholar
  • 29 Rothstein HR, Sutton AJ, Borenstein M. Publication bias in meta-analysis: Prevention, Assessment and Adjustments. Wiley; 2005
    Google Scholar
  • 30 Irani S, Yang J, Khashab MA. Mitigating lumen-apposing metal stent dislodgment and allowing safe, single-stage EUS-directed transgastric ERCP. VideoGIE 2018; 3: 322-324
    CrossrefPubMedGoogle Scholar
  • 31 Kedia P, Kumta NA, Sharaiha R. et al. Bypassing the bypass: EUS-directed transgastric ERCP for Roux-en-Y anatomy. Gastrointest Endosc 2015; 81: 223-224
    CrossrefPubMedGoogle Scholar
  • 32 Tyberg A, Nieto J, Salgado S. et al. Endoscopic ultrasound (EUS)-directed transgastric endoscopic retrograde cholangiopancreatography or EUS: mid-term analysis of an emerging procedure. Clin Endosc 2017; 50: 185-190
    CrossrefPubMedGoogle Scholar
  • 33 Kedia P, Tarnasky PR, Nieto J. et al. EUS-directed transgastric ERCP (EDGE) versus laparoscopy-assisted ERCP (LA-ERCP) for Roux-en-Y gastric bypass (RYGB) anatomy: a multicenter early comparative experience of clinical outcomes. J Clin Gastroenterol 2019; 53: 304-308
    CrossrefPubMedGoogle Scholar
  • 34 Ngamruengphong S, Nieto J, Kunda R. et al. Endoscopic ultrasound-guided creation of a transgastric fistula for the management of hepatobiliary disease in patients with Roux-en-Y gastric bypass. Endoscopy 2017; 49: 549-552
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 35 Bukhari M, Kowalski T, Nieto J. et al. An international, multicenter, comparative trial of EUS-guided gastrogastrostomy-assisted ERCP versus enteroscopy-assisted ERCP in patients with Roux-en-Y gastric bypass anatomy. Gastrointest Endosc 2018; 88: 486-494
    CrossrefPubMedGoogle Scholar
  • 36 Bertin PM, Singh K, Arregui ME. Laparoscopic transgastric endoscopic retrograde cholangiopancreatography (ERCP) after gastric bypass: case series and a description of technique. Surg Endosc 2011; 25: 2592-2596
    CrossrefPubMedGoogle Scholar
  • 37 Bowman E, Greenberg J, Garren M. et al. Laparoscopic-assisted ERCP and EUS in patients with prior Roux-en-Y gastric bypass surgery: a dual-center case series experience. Surg Endosc 2016; 30: 4647-4652
    CrossrefPubMedGoogle Scholar
  • 38 May DD, Parker DM, Vogels ED. et al. Outcomes of laparoscopic-assisted ERCP after Roux-En-Y gastric bypass: safe and effective for management of sphincter of Oddi dysfunction. Endosc Int Open 2019; 7: E1276-E1280
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 39 Falcao M, Campos JM, Galvao Neto M. et al. Transgastric endoscopic retrograde cholangiopancreatography for the management of biliary tract disease after Roux-en-Y gastric bypass treatment for obesity. Obes Surg 2012; 22: 872-876
    CrossrefPubMedGoogle Scholar
  • 40 Farukhi MCB, Davis B. et al. Treatment of biliary disease with transgastric ERCP after Roux-En-Y gastric bypass. Surg Endosc 2016; S325-500
    PubMedGoogle Scholar
  • 41 Frederiksen NA, Tveskov L, Helgstrand F. et al. Treatment of common bile duct stones in gastric bypass patients with laparoscopic transgastric endoscopic retrograde cholangiopancreatography. Obes Surg 2017; 27: 1409-1413
    CrossrefPubMedGoogle Scholar
  • 42 Grimes KL, Maciel VH, Mata W. et al. Complications of laparoscopic transgastric ERCP in patients with Roux-en-Y gastric bypass. Surg Endosc 2015; 29: 1753-1759
    CrossrefPubMedGoogle Scholar
  • 43 Habenicht Yancey K, McCormack LK, McNatt SS. et al. Laparoscopic-assisted transgastric ERCP: a single-institution experience. J Obes 2018; 2018: 8275965
    PubMedGoogle Scholar
  • 44 Kumar U, Kroner PT, Jovanovic I. et al. Balloon-overtube enteroscopy assisted (BAE) versus laparoscopy-assisted ERCP in Bariatric Post-Roux-en-Y gastric bypass patients: a comparative study. Gastrointest Endosc 2016; 83: AB298
    PubMedGoogle Scholar
  • 45 Lin C, Aragon RJ, Carr AD. et al. Direct access ERCP: a novel and reliable surgical technique for patients with Roux-en-Y anatomy. Surg Endosc 2014; 28: 311
    CrossrefPubMedGoogle Scholar
  • 46 Mejia R, Achurra P, Gabrielli M. et al. Laparoscopy-assisted trans-gastric rendez-vous for the treatment of common bile duct stones in patients with prior Roux-en-Y gastric bypass. Obes Surg 2016; 26: 2809-2813
    CrossrefPubMedGoogle Scholar
  • 47 Paranandi B, Joshi D, Mohammadi B. et al. Laparoscopy-assisted ERCP (LA-ERCP) following bariatric gastric bypass surgery: initial experience of a single UK centre. Frontline Gastroenterol 2016; 7: 54-59
    CrossrefPubMedGoogle Scholar
  • 48 Saleem A, Levy MJ, Petersen BT. et al. Laparoscopic assisted ERCP in Roux-en-Y gastric bypass (RYGB) surgery patients. J Gastrointest Surg 2012; 16: 203-208
    CrossrefPubMedGoogle Scholar
  • 49 Schreiner MA, Chang L, Gluck M. et al. Laparoscopy-assisted versus balloon enteroscopy-assisted ERCP in bariatric post-Roux-en-Y gastric bypass patients. Gastrointest Endosc 2012; 75: 748-756
    CrossrefPubMedGoogle Scholar
  • 50 Snauwaert C, Laukens P, Dillemans B. et al. Laparoscopy-assisted transgastric endoscopic retrograde cholangiopancreatography in bariatric Roux-en-Y gastric bypass patients. Endosc Int Open 2015; 3: E458-E463
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 51 Sun Z, Rodriguez J, Albeldawi M. et al. Laparoscopic transgastric endoscopic retrograde cholangiopancreatography for the treatment of biliary tract disease after Roux-en-Y gastric bypass. J Am Coll Surg 2014; 219: e60-e61
    PubMedGoogle Scholar
  • 52 Choi EK, Chiorean MV, Cote GA. et al. ERCP via gastrostomy vs. double balloon enteroscopy in patients with prior bariatric Roux-en-Y gastric bypass surgery. Surg Endosc 2013; 27: 2894-2899
    CrossrefPubMedGoogle Scholar
  • 53 Kashani A, Abboud G, Lo SK. et al. Double balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography in Roux-en-Y gastric bypass anatomy: expert vs. novice experience. Endosc Int Open 2018; 6: E885-E891
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 54 Mohan BP, Adler DG. Heterogeneity in systematic review and meta-analysis: how to read between the numbers. Gastrointest Endosc 2019; 89: 902-903
    CrossrefPubMedGoogle Scholar