Improved techniques for double-balloon-enteroscopy-assisted endoscopic retrograde cholangiopancreatography

Takashi Osoegawa, Yasuaki Motomura, Kazuya Akahoshi, Naomi Higuchi, Yoshimasa Tanaka, Terumasa Hisano, Souichi Itaba, Junya Gibo, Mariko Yamada, Masaru Kubokawa, Yorinobu Sumida, Hirotada Akiho, Eikichi Ihara, Kazuhiko Nakamura

研究成果: ジャーナルへの寄稿記事

31 引用 (Scopus)

抄録

AIM: To investigate the clinical outcome of double balloon enteroscopy (DBE)-assisted endoscopic retrograde cholangiopancreatography (DB-ERCP) in patients with altered gastrointestinal anatomy. METHODS: Between September 2006 and April 2011, 47 procedures of DB-ERCP were performed in 28 patients with a Roux-en-Y total gastrectomy (n = 11), Billroth II gastrectomy (n = 15), or Roux-en-Y anastomosis with hepaticojejunostomy (n = 2). DB-ERCP was performed using a short-type DBE combined with several technical innovations such as using an endoscope attachment, marking by submucosal tattooing, selectively applying contrast medium, and CO2 insufflations. RESULTS: The papilla of Vater or hepaticojejunostomy site was reached in its entirety with a 96% success rate (45/47 procedures). There were no significant differences in the success rate of reaching the blind end with a DBE among Roux-en-Y total gastrectomy (96%), Billroth II reconstruction (94%), or pancreatoduodenectomy (100%), respectively (P = 0.91). The total successful rate of cannulation and contrast enhancement of the target bile duct in patients whom the blind end was reached with a DBE was 40/45 procedures (89%). Again, there were no significant differences in the success rate of cannulation and contrast enhancement of the target bile duct with a DBE among Roux-en-Y total gastrectomy (88%), Billroth II reconstruction (89%), or pancreatoduodenectomy (100%), respectively (P = 0.67). Treatment was achieved in all 40 procedures (100%) in patients whom the contrast enhancement of the bile duct was successful. Common endoscopic treatments were endoscopic biliary drainage (24 procedures) and extraction of stones (14 procedures). Biliary drainage was done by placement of plastic stents. Stones extraction was done by lithotomy with the mechanical lithotripter followed by extraction with a basket or by the balloon pull-through method. Endoscopic sphincterotomy was performed in 14 procedures with a needle precutting knife using a guidewire. The mean total duration of the procedure was 93.6 ± 6.8 min and the mean time required to reach the papilla was 30.5 ± 3.7 min. The mean time required to reach the papilla tended to be shorter in Billroth II reconstruction (20.9 ± 5.8 min) than that in Roux-en-Y total gastrectomy (37.1 ± 4.9 min) but there was no significant difference (P = 0.09). A major complication occurred in one patient (3.5%); perforation of the long limb in a patient with Billroth II anastomosis. CONCLUSION: Short-type DBE combined with several technical innovations enabled us to perform ERCP in most patients with altered gastrointestinal anatomy.

元の言語英語
ページ(範囲)6843-6849
ページ数7
ジャーナルWorld Journal of Gastroenterology
18
発行部数46
DOI
出版物ステータス出版済み - 12 1 2012

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Double-Balloon Enteroscopy
Endoscopic Retrograde Cholangiopancreatography
Gastroenterostomy
Gastrectomy
Bile Ducts
Pancreaticoduodenectomy
Catheterization
Drainage
Anatomy
Roux-en-Y Anastomosis
Tattooing
Endoscopic Sphincterotomy
Insufflation
Endoscopes
Contrast Media
Plastics
Needles
Stents
Extremities

All Science Journal Classification (ASJC) codes

  • Gastroenterology

これを引用

Osoegawa, T., Motomura, Y., Akahoshi, K., Higuchi, N., Tanaka, Y., Hisano, T., ... Nakamura, K. (2012). Improved techniques for double-balloon-enteroscopy-assisted endoscopic retrograde cholangiopancreatography. World Journal of Gastroenterology, 18(46), 6843-6849. https://doi.org/10.3748/wjg.v18.i46.6843

Improved techniques for double-balloon-enteroscopy-assisted endoscopic retrograde cholangiopancreatography. / Osoegawa, Takashi; Motomura, Yasuaki; Akahoshi, Kazuya; Higuchi, Naomi; Tanaka, Yoshimasa; Hisano, Terumasa; Itaba, Souichi; Gibo, Junya; Yamada, Mariko; Kubokawa, Masaru; Sumida, Yorinobu; Akiho, Hirotada; Ihara, Eikichi; Nakamura, Kazuhiko.

:: World Journal of Gastroenterology, 巻 18, 番号 46, 01.12.2012, p. 6843-6849.

研究成果: ジャーナルへの寄稿記事

Osoegawa, T, Motomura, Y, Akahoshi, K, Higuchi, N, Tanaka, Y, Hisano, T, Itaba, S, Gibo, J, Yamada, M, Kubokawa, M, Sumida, Y, Akiho, H, Ihara, E & Nakamura, K 2012, 'Improved techniques for double-balloon-enteroscopy-assisted endoscopic retrograde cholangiopancreatography', World Journal of Gastroenterology, 巻. 18, 番号 46, pp. 6843-6849. https://doi.org/10.3748/wjg.v18.i46.6843
Osoegawa, Takashi ; Motomura, Yasuaki ; Akahoshi, Kazuya ; Higuchi, Naomi ; Tanaka, Yoshimasa ; Hisano, Terumasa ; Itaba, Souichi ; Gibo, Junya ; Yamada, Mariko ; Kubokawa, Masaru ; Sumida, Yorinobu ; Akiho, Hirotada ; Ihara, Eikichi ; Nakamura, Kazuhiko. / Improved techniques for double-balloon-enteroscopy-assisted endoscopic retrograde cholangiopancreatography. :: World Journal of Gastroenterology. 2012 ; 巻 18, 番号 46. pp. 6843-6849.
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abstract = "AIM: To investigate the clinical outcome of double balloon enteroscopy (DBE)-assisted endoscopic retrograde cholangiopancreatography (DB-ERCP) in patients with altered gastrointestinal anatomy. METHODS: Between September 2006 and April 2011, 47 procedures of DB-ERCP were performed in 28 patients with a Roux-en-Y total gastrectomy (n = 11), Billroth II gastrectomy (n = 15), or Roux-en-Y anastomosis with hepaticojejunostomy (n = 2). DB-ERCP was performed using a short-type DBE combined with several technical innovations such as using an endoscope attachment, marking by submucosal tattooing, selectively applying contrast medium, and CO2 insufflations. RESULTS: The papilla of Vater or hepaticojejunostomy site was reached in its entirety with a 96{\%} success rate (45/47 procedures). There were no significant differences in the success rate of reaching the blind end with a DBE among Roux-en-Y total gastrectomy (96{\%}), Billroth II reconstruction (94{\%}), or pancreatoduodenectomy (100{\%}), respectively (P = 0.91). The total successful rate of cannulation and contrast enhancement of the target bile duct in patients whom the blind end was reached with a DBE was 40/45 procedures (89{\%}). Again, there were no significant differences in the success rate of cannulation and contrast enhancement of the target bile duct with a DBE among Roux-en-Y total gastrectomy (88{\%}), Billroth II reconstruction (89{\%}), or pancreatoduodenectomy (100{\%}), respectively (P = 0.67). Treatment was achieved in all 40 procedures (100{\%}) in patients whom the contrast enhancement of the bile duct was successful. Common endoscopic treatments were endoscopic biliary drainage (24 procedures) and extraction of stones (14 procedures). Biliary drainage was done by placement of plastic stents. Stones extraction was done by lithotomy with the mechanical lithotripter followed by extraction with a basket or by the balloon pull-through method. Endoscopic sphincterotomy was performed in 14 procedures with a needle precutting knife using a guidewire. The mean total duration of the procedure was 93.6 ± 6.8 min and the mean time required to reach the papilla was 30.5 ± 3.7 min. The mean time required to reach the papilla tended to be shorter in Billroth II reconstruction (20.9 ± 5.8 min) than that in Roux-en-Y total gastrectomy (37.1 ± 4.9 min) but there was no significant difference (P = 0.09). A major complication occurred in one patient (3.5{\%}); perforation of the long limb in a patient with Billroth II anastomosis. CONCLUSION: Short-type DBE combined with several technical innovations enabled us to perform ERCP in most patients with altered gastrointestinal anatomy.",
author = "Takashi Osoegawa and Yasuaki Motomura and Kazuya Akahoshi and Naomi Higuchi and Yoshimasa Tanaka and Terumasa Hisano and Souichi Itaba and Junya Gibo and Mariko Yamada and Masaru Kubokawa and Yorinobu Sumida and Hirotada Akiho and Eikichi Ihara and Kazuhiko Nakamura",
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TY - JOUR

T1 - Improved techniques for double-balloon-enteroscopy-assisted endoscopic retrograde cholangiopancreatography

AU - Osoegawa, Takashi

AU - Motomura, Yasuaki

AU - Akahoshi, Kazuya

AU - Higuchi, Naomi

AU - Tanaka, Yoshimasa

AU - Hisano, Terumasa

AU - Itaba, Souichi

AU - Gibo, Junya

AU - Yamada, Mariko

AU - Kubokawa, Masaru

AU - Sumida, Yorinobu

AU - Akiho, Hirotada

AU - Ihara, Eikichi

AU - Nakamura, Kazuhiko

PY - 2012/12/1

Y1 - 2012/12/1

N2 - AIM: To investigate the clinical outcome of double balloon enteroscopy (DBE)-assisted endoscopic retrograde cholangiopancreatography (DB-ERCP) in patients with altered gastrointestinal anatomy. METHODS: Between September 2006 and April 2011, 47 procedures of DB-ERCP were performed in 28 patients with a Roux-en-Y total gastrectomy (n = 11), Billroth II gastrectomy (n = 15), or Roux-en-Y anastomosis with hepaticojejunostomy (n = 2). DB-ERCP was performed using a short-type DBE combined with several technical innovations such as using an endoscope attachment, marking by submucosal tattooing, selectively applying contrast medium, and CO2 insufflations. RESULTS: The papilla of Vater or hepaticojejunostomy site was reached in its entirety with a 96% success rate (45/47 procedures). There were no significant differences in the success rate of reaching the blind end with a DBE among Roux-en-Y total gastrectomy (96%), Billroth II reconstruction (94%), or pancreatoduodenectomy (100%), respectively (P = 0.91). The total successful rate of cannulation and contrast enhancement of the target bile duct in patients whom the blind end was reached with a DBE was 40/45 procedures (89%). Again, there were no significant differences in the success rate of cannulation and contrast enhancement of the target bile duct with a DBE among Roux-en-Y total gastrectomy (88%), Billroth II reconstruction (89%), or pancreatoduodenectomy (100%), respectively (P = 0.67). Treatment was achieved in all 40 procedures (100%) in patients whom the contrast enhancement of the bile duct was successful. Common endoscopic treatments were endoscopic biliary drainage (24 procedures) and extraction of stones (14 procedures). Biliary drainage was done by placement of plastic stents. Stones extraction was done by lithotomy with the mechanical lithotripter followed by extraction with a basket or by the balloon pull-through method. Endoscopic sphincterotomy was performed in 14 procedures with a needle precutting knife using a guidewire. The mean total duration of the procedure was 93.6 ± 6.8 min and the mean time required to reach the papilla was 30.5 ± 3.7 min. The mean time required to reach the papilla tended to be shorter in Billroth II reconstruction (20.9 ± 5.8 min) than that in Roux-en-Y total gastrectomy (37.1 ± 4.9 min) but there was no significant difference (P = 0.09). A major complication occurred in one patient (3.5%); perforation of the long limb in a patient with Billroth II anastomosis. CONCLUSION: Short-type DBE combined with several technical innovations enabled us to perform ERCP in most patients with altered gastrointestinal anatomy.

AB - AIM: To investigate the clinical outcome of double balloon enteroscopy (DBE)-assisted endoscopic retrograde cholangiopancreatography (DB-ERCP) in patients with altered gastrointestinal anatomy. METHODS: Between September 2006 and April 2011, 47 procedures of DB-ERCP were performed in 28 patients with a Roux-en-Y total gastrectomy (n = 11), Billroth II gastrectomy (n = 15), or Roux-en-Y anastomosis with hepaticojejunostomy (n = 2). DB-ERCP was performed using a short-type DBE combined with several technical innovations such as using an endoscope attachment, marking by submucosal tattooing, selectively applying contrast medium, and CO2 insufflations. RESULTS: The papilla of Vater or hepaticojejunostomy site was reached in its entirety with a 96% success rate (45/47 procedures). There were no significant differences in the success rate of reaching the blind end with a DBE among Roux-en-Y total gastrectomy (96%), Billroth II reconstruction (94%), or pancreatoduodenectomy (100%), respectively (P = 0.91). The total successful rate of cannulation and contrast enhancement of the target bile duct in patients whom the blind end was reached with a DBE was 40/45 procedures (89%). Again, there were no significant differences in the success rate of cannulation and contrast enhancement of the target bile duct with a DBE among Roux-en-Y total gastrectomy (88%), Billroth II reconstruction (89%), or pancreatoduodenectomy (100%), respectively (P = 0.67). Treatment was achieved in all 40 procedures (100%) in patients whom the contrast enhancement of the bile duct was successful. Common endoscopic treatments were endoscopic biliary drainage (24 procedures) and extraction of stones (14 procedures). Biliary drainage was done by placement of plastic stents. Stones extraction was done by lithotomy with the mechanical lithotripter followed by extraction with a basket or by the balloon pull-through method. Endoscopic sphincterotomy was performed in 14 procedures with a needle precutting knife using a guidewire. The mean total duration of the procedure was 93.6 ± 6.8 min and the mean time required to reach the papilla was 30.5 ± 3.7 min. The mean time required to reach the papilla tended to be shorter in Billroth II reconstruction (20.9 ± 5.8 min) than that in Roux-en-Y total gastrectomy (37.1 ± 4.9 min) but there was no significant difference (P = 0.09). A major complication occurred in one patient (3.5%); perforation of the long limb in a patient with Billroth II anastomosis. CONCLUSION: Short-type DBE combined with several technical innovations enabled us to perform ERCP in most patients with altered gastrointestinal anatomy.

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