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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
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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.



Publication History

Received: 06 July 2020

Accepted: 16 November 2020

Accepted Manuscript online:
16 November 2020

Article published online:
12 January 2021

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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