PDF herunterladen
Endoscopy 2021; 53(09): 927-931
DOI: 10.1055/a-1311-9779
Innovations and brief communications

Underwater cap-assisted endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy: a pilot study

Alessandro Fugazza 
1   Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center – IRCCS, Rozzano, Milan, Italy
,
Andrea Anderloni
1   Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center – IRCCS, Rozzano, Milan, Italy
,
Danilo Paduano 
1   Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center – IRCCS, Rozzano, Milan, Italy
,
Matteo Badalamenti
1   Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center – IRCCS, Rozzano, Milan, Italy
,
Roberta Maselli
1   Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center – IRCCS, Rozzano, Milan, Italy
,
Silvia Carrara
1   Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center – IRCCS, Rozzano, Milan, Italy
,
Roberto Gabbiadini
1   Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center – IRCCS, Rozzano, Milan, Italy
,
Matteo Colombo
1   Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center – IRCCS, Rozzano, Milan, Italy
,
Marco Spadaccini
1   Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center – IRCCS, Rozzano, Milan, Italy
,
Annalisa Cappello 
1   Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center – IRCCS, Rozzano, Milan, Italy
,
Gregory Haber
2   Division of Gastroenterology, Lenox Hill Hospital, New York, New York, USA
,
Alessandro Repici
1   Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center – IRCCS, Rozzano, Milan, Italy
3   Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
    Lizenzen und Reprints

Abstract

Introduction Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy (SAA) is technically challenging and associated with a significant number of failures. We examined the feasibility and efficacy of a novel technique for the management of bile duct stones (BDSs), called underwater cap-assisted ERCP (u-ERCP).

Methods Between June 2019 and February 2020 all patients with SAA with jaundice or cholangitis secondary to BDSs who underwent u-ERCP were enrolled. The u-ERCP technique 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 success, and adverse events associated with u-ERCP.

Results We describe the technique itself and our initial experience in six patients. A complete and successful procedure was carried out in all patients, with the occurrence of no adverse events. None of the patients needed additional treatments for recurrence of symptoms during the follow-up period.

Conclusions u-ERCP can be considered as a promising alternative for successful endoscopic management of biliary disease in patients with SAA.



Publikationsverlauf

Eingereicht: 06. Juli 2020

Angenommen: 16. November 2020

Accepted Manuscript online:
16. November 2020

Artikel online veröffentlicht:
12. Januar 2021

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Krutsri C, Kida M, Yamauchi H. et al. Current status of endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy. World J Gastroenterol 2019; 25: 3313-3333
    CrossrefPubMedSuche in Google Scholar
  • 2 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
    CrossrefPubMedSuche in Google Scholar
  • 3 Wright BE, Cass OW, Freeman ML. ERCP in patients with long-limb Roux-en-Y gastrojejunostomy and intact papilla. Gastrointest Endosc 2002; 56: 225-232
    CrossrefPubMedSuche in Google Scholar
  • 4 Nakai Y, Kogure H, Yamada A. et al. Endoscopic management of bile duct stones in patients with surgically altered anatomy. Dig Endosc 2018; 30: 67-74
    CrossrefPubMedSuche in Google Scholar
  • 5 Yamada A, Kogure H, Nakai Y. et al. Performance of a new short-type double-balloon endoscope with advanced force transmission and adaptive bending for pancreaticobiliary intervention in patients with surgically altered anatomy: A propensity-matched analysis. Dig Endosc 2019; 31: 86-93
    CrossrefPubMedSuche in Google Scholar
  • 6 Shah RJ, Smolkin M, Yen R. et al. A multicenter, U.S. experience of single-balloon, double-balloon, and rotational overtube-assisted enteroscopy ERCP in patients with surgically altered pancreaticobiliary anatomy (with video). Gastrointest Endosc 2013; 77: 593-600
    CrossrefPubMedSuche in Google Scholar
  • 7 Shimatani M, Hatanaka H, Kogure H. et al. Diagnostic and therapeutic endoscopic retrograde cholangiography using a short-type double-balloon endoscope in patients with altered gastrointestinal anatomy: a multicenter prospective study in Japan. Am J Gastroenterol 2016; 111: 1750-1758
    CrossrefPubMedSuche in Google Scholar
  • 8 Trindade AJ, Mella JM, Slattery E. et al. Use of a cap in single-balloon enteroscopy-assisted endoscopic retrograde cholangiography. Endoscopy 2015; 47: 453-456
    Thieme ConnectPubMedSuche in Google Scholar
  • 9 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
    CrossrefPubMedSuche in Google Scholar
  • 10 Fuccio L, Frazzoni L, Hassan C. et al. Water exchange colonoscopy increases adenoma detection rate: a systematic review with network meta-analysis of randomized controlled studies. Gastrointest Endosc 2018; 88: 589-597
    CrossrefPubMedSuche in Google Scholar
  • 11 Yane K, Katanuma A, Maguchi H. et al. Short-type single-balloon enteroscope-assisted ERCP in postsurgical altered anatomy: potential factors affecting procedural failure. Endoscopy 2017; 49: 69-74
    PubMedSuche in Google Scholar
  • 12 Morgan JL, Thomas K, Braungart S. et al. Transparent cap colonoscopy versus standard colonoscopy: a systematic review and meta-analysis. Tech Coloproctol 2013; 17: 353-360
    CrossrefPubMedSuche in Google Scholar
  • 13 Tseng CW, Koo M, Hsieh YH. Cecal intubation time between cap-assisted water exchange and water exchange colonoscopy: a randomized-controlled trial. Eur J Gastroenterol Hepatol 2017; 29: 1296-1302
    CrossrefPubMedSuche in Google Scholar
  • 14 Nakaji S, Hirata N, Yamauchi K. et al. Endoscopic retrograde cholangiopancreatography using a cap-assisted highly flexible colonoscope in patients with Roux-en-Y anastomosis. Endoscopy 2014; 46: 529-532
    Thieme ConnectPubMedSuche in Google Scholar