Endoscopic retrograde cholangiopancreatography in patients with surgically altered gastrointestinal anatomy: A retrospective study

Takaaki Fujimoto, Yasuhisa Mori, Yohei Nakashima, Takao Ohtsuka, So Nakamura, Yoshitaka Gotoh, Kenjiro Date, Yoshihiko Sadakari, Kohei Nakata, Yoshihiro Miyasaka, Takashi Osoegawa, Akira Aso, Eikichi Ihara, Kazuhiko Nakamura, Yoshihiro Ogawa, Shuji Shimizu, Masafumi Nakamura

Research output: Contribution to journalArticle

Abstract

Objective: The aim of this study was to evaluate the difficulty of endoscopic retrograde cholangiopancreatography (ERCP) procedures when performed in patients with different types of surgically altered gastrointestinal (GI) anatomies. Summary of background data: Clinical data of 102 consecutive patients with surgically altered GI anatomy who underwent ERCP using a double-balloon enteroscope or a regular gastroendoscope between January 2008 and March 2015 were retrospectively reviewed. Methods: The success rate of reaching the destination, the time until reaching the destination, the success rate of the procedures, and complications were assessed for each type of altered GI anatomy using a double-balloon enteroscope and a regular gastroendoscope. Results: A total of 180 ERCP procedures were performed. The total success rate of reaching the destination was 91% (164 of 180), and that of treatment was 88% (144 of 164). The success rate of reaching the destination in patients with Roux-en-Y hepaticojejunostomy (HJ þ R-Y) was significantly lower than that of the other types of reconstruction. The time until reaching the destination was significantly longer in patients after R-Y reconstruction (gastrectomy or HJ) than that after Billroth-II gastrectomy or pancreatoduodenectomy. GI perforation occurred in 2 patients after R-Y reconstruction (1 patient after gastrectomy, and 1 patient after HJ). However, no other complications, such as severe pancreatitis, bleeding, or air embolism, were observed. Conclusions: ERCP for patients with surgically altered GI anatomy is feasible. Improvement of the success rate of reaching the destination in patients after HJ þ R-Y and prevention of perforation in those with R-Y reconstruction are necessary.

Original languageEnglish
Pages (from-to)184-190
Number of pages7
JournalInternational Surgery
Volume103
Issue number3-4
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Endoscopic Retrograde Cholangiopancreatography
Anatomy
Retrospective Studies
Gastrectomy
Gastroenterostomy
Air Embolism
Pancreaticoduodenectomy
Pancreatitis
Hemorrhage

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Endoscopic retrograde cholangiopancreatography in patients with surgically altered gastrointestinal anatomy : A retrospective study. / Fujimoto, Takaaki; Mori, Yasuhisa; Nakashima, Yohei; Ohtsuka, Takao; Nakamura, So; Gotoh, Yoshitaka; Date, Kenjiro; Sadakari, Yoshihiko; Nakata, Kohei; Miyasaka, Yoshihiro; Osoegawa, Takashi; Aso, Akira; Ihara, Eikichi; Nakamura, Kazuhiko; Ogawa, Yoshihiro; Shimizu, Shuji; Nakamura, Masafumi.

In: International Surgery, Vol. 103, No. 3-4, 01.01.2019, p. 184-190.

Research output: Contribution to journalArticle

Fujimoto, Takaaki ; Mori, Yasuhisa ; Nakashima, Yohei ; Ohtsuka, Takao ; Nakamura, So ; Gotoh, Yoshitaka ; Date, Kenjiro ; Sadakari, Yoshihiko ; Nakata, Kohei ; Miyasaka, Yoshihiro ; Osoegawa, Takashi ; Aso, Akira ; Ihara, Eikichi ; Nakamura, Kazuhiko ; Ogawa, Yoshihiro ; Shimizu, Shuji ; Nakamura, Masafumi. / Endoscopic retrograde cholangiopancreatography in patients with surgically altered gastrointestinal anatomy : A retrospective study. In: International Surgery. 2019 ; Vol. 103, No. 3-4. pp. 184-190.
@article{c2e5e5491272456fb0969de686a7cc0d,
title = "Endoscopic retrograde cholangiopancreatography in patients with surgically altered gastrointestinal anatomy: A retrospective study",
abstract = "Objective: The aim of this study was to evaluate the difficulty of endoscopic retrograde cholangiopancreatography (ERCP) procedures when performed in patients with different types of surgically altered gastrointestinal (GI) anatomies. Summary of background data: Clinical data of 102 consecutive patients with surgically altered GI anatomy who underwent ERCP using a double-balloon enteroscope or a regular gastroendoscope between January 2008 and March 2015 were retrospectively reviewed. Methods: The success rate of reaching the destination, the time until reaching the destination, the success rate of the procedures, and complications were assessed for each type of altered GI anatomy using a double-balloon enteroscope and a regular gastroendoscope. Results: A total of 180 ERCP procedures were performed. The total success rate of reaching the destination was 91{\%} (164 of 180), and that of treatment was 88{\%} (144 of 164). The success rate of reaching the destination in patients with Roux-en-Y hepaticojejunostomy (HJ {\th} R-Y) was significantly lower than that of the other types of reconstruction. The time until reaching the destination was significantly longer in patients after R-Y reconstruction (gastrectomy or HJ) than that after Billroth-II gastrectomy or pancreatoduodenectomy. GI perforation occurred in 2 patients after R-Y reconstruction (1 patient after gastrectomy, and 1 patient after HJ). However, no other complications, such as severe pancreatitis, bleeding, or air embolism, were observed. Conclusions: ERCP for patients with surgically altered GI anatomy is feasible. Improvement of the success rate of reaching the destination in patients after HJ {\th} R-Y and prevention of perforation in those with R-Y reconstruction are necessary.",
author = "Takaaki Fujimoto and Yasuhisa Mori and Yohei Nakashima and Takao Ohtsuka and So Nakamura and Yoshitaka Gotoh and Kenjiro Date and Yoshihiko Sadakari and Kohei Nakata and Yoshihiro Miyasaka and Takashi Osoegawa and Akira Aso and Eikichi Ihara and Kazuhiko Nakamura and Yoshihiro Ogawa and Shuji Shimizu and Masafumi Nakamura",
year = "2019",
month = "1",
day = "1",
doi = "10.9738/INTSURG-D-17-00137.1",
language = "English",
volume = "103",
pages = "184--190",
journal = "International Surgery",
issn = "0020-8868",
publisher = "International College of Surgeons",
number = "3-4",

}

TY - JOUR

T1 - Endoscopic retrograde cholangiopancreatography in patients with surgically altered gastrointestinal anatomy

T2 - A retrospective study

AU - Fujimoto, Takaaki

AU - Mori, Yasuhisa

AU - Nakashima, Yohei

AU - Ohtsuka, Takao

AU - Nakamura, So

AU - Gotoh, Yoshitaka

AU - Date, Kenjiro

AU - Sadakari, Yoshihiko

AU - Nakata, Kohei

AU - Miyasaka, Yoshihiro

AU - Osoegawa, Takashi

AU - Aso, Akira

AU - Ihara, Eikichi

AU - Nakamura, Kazuhiko

AU - Ogawa, Yoshihiro

AU - Shimizu, Shuji

AU - Nakamura, Masafumi

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: The aim of this study was to evaluate the difficulty of endoscopic retrograde cholangiopancreatography (ERCP) procedures when performed in patients with different types of surgically altered gastrointestinal (GI) anatomies. Summary of background data: Clinical data of 102 consecutive patients with surgically altered GI anatomy who underwent ERCP using a double-balloon enteroscope or a regular gastroendoscope between January 2008 and March 2015 were retrospectively reviewed. Methods: The success rate of reaching the destination, the time until reaching the destination, the success rate of the procedures, and complications were assessed for each type of altered GI anatomy using a double-balloon enteroscope and a regular gastroendoscope. Results: A total of 180 ERCP procedures were performed. The total success rate of reaching the destination was 91% (164 of 180), and that of treatment was 88% (144 of 164). The success rate of reaching the destination in patients with Roux-en-Y hepaticojejunostomy (HJ þ R-Y) was significantly lower than that of the other types of reconstruction. The time until reaching the destination was significantly longer in patients after R-Y reconstruction (gastrectomy or HJ) than that after Billroth-II gastrectomy or pancreatoduodenectomy. GI perforation occurred in 2 patients after R-Y reconstruction (1 patient after gastrectomy, and 1 patient after HJ). However, no other complications, such as severe pancreatitis, bleeding, or air embolism, were observed. Conclusions: ERCP for patients with surgically altered GI anatomy is feasible. Improvement of the success rate of reaching the destination in patients after HJ þ R-Y and prevention of perforation in those with R-Y reconstruction are necessary.

AB - Objective: The aim of this study was to evaluate the difficulty of endoscopic retrograde cholangiopancreatography (ERCP) procedures when performed in patients with different types of surgically altered gastrointestinal (GI) anatomies. Summary of background data: Clinical data of 102 consecutive patients with surgically altered GI anatomy who underwent ERCP using a double-balloon enteroscope or a regular gastroendoscope between January 2008 and March 2015 were retrospectively reviewed. Methods: The success rate of reaching the destination, the time until reaching the destination, the success rate of the procedures, and complications were assessed for each type of altered GI anatomy using a double-balloon enteroscope and a regular gastroendoscope. Results: A total of 180 ERCP procedures were performed. The total success rate of reaching the destination was 91% (164 of 180), and that of treatment was 88% (144 of 164). The success rate of reaching the destination in patients with Roux-en-Y hepaticojejunostomy (HJ þ R-Y) was significantly lower than that of the other types of reconstruction. The time until reaching the destination was significantly longer in patients after R-Y reconstruction (gastrectomy or HJ) than that after Billroth-II gastrectomy or pancreatoduodenectomy. GI perforation occurred in 2 patients after R-Y reconstruction (1 patient after gastrectomy, and 1 patient after HJ). However, no other complications, such as severe pancreatitis, bleeding, or air embolism, were observed. Conclusions: ERCP for patients with surgically altered GI anatomy is feasible. Improvement of the success rate of reaching the destination in patients after HJ þ R-Y and prevention of perforation in those with R-Y reconstruction are necessary.

UR - http://www.scopus.com/inward/record.url?scp=85069806040&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85069806040&partnerID=8YFLogxK

U2 - 10.9738/INTSURG-D-17-00137.1

DO - 10.9738/INTSURG-D-17-00137.1

M3 - Article

AN - SCOPUS:85069806040

VL - 103

SP - 184

EP - 190

JO - International Surgery

JF - International Surgery

SN - 0020-8868

IS - 3-4

ER -