Year 2020 / Volume 112 / Number 12
Original
Single-balloon enteroscopy-assisted ERCP in patients with Roux-en-Y anatomy and choledocholithiasis: do technical improvements mean better outcomes?

929-934

DOI: 10.17235/reed.2020.7287/2020

Jesús Espinel Díez, María Eugenia Pinedo Ramos,

Abstract
Background: endoscopic retrograde cholangiopancreatography (ERCP) in patients with Roux-en-Y anatomy is challenging. Single-balloon enteroscopy-assisted ERCP (SBE-ERCP) is an innovative alternative to reach the bile duct. Objective: to report our experience in SBE-ERCP in patients who presented with Roux-en-Y anatomy and choledocholithiasis. Patients and methods: patients who presented choledocholithiasis and underwent SBE-ERCP between January 2018 and April 2020 were retrospectively identified via medical records and the digestive endoscopy database. Enteroscopy success was defined as reaching the biliary limb and papilla identification. ERCP diagnostic success was defined as a successful duct cannulation and cholangiography, and ERCP procedural success was defined as the ability to successfully carry out choledocholithiasis extraction. Complications of ERCP were defined according to standard criteria. Results: a total of eleven patients (two females) with a mean age of 81 years (range 60-91 years) with Roux-en-Y anastomosis underwent ERCP using a SBE on 13 occasions. The indication for all procedures was choledocholithiasis, which had been previously confirmed by magnetic resonance cholangiopancreatography (MRCP). Enteroscopy success occurred in 13/13 (100 %) of procedures. Overall ERCP diagnostic success was achieved in 11/13 (84.6 %) of procedures. The ERCP procedural success was obtained in 11/11 (100 %) of patients (84.6 % of procedures). A mild pancreatitis occurred in a patient with native papilla. Conclusions: SBE-ERCP is feasible, efficacious and safe in patients with postsurgical Roux-en-Y anatomy and choledocholithiasis. Technical improvements may mean better outcomes.
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Espinel Díez J, Pinedo Ramos M. Single-balloon enteroscopy-assisted ERCP in patients with Roux-en-Y anatomy and choledocholithiasis: do technical improvements mean better outcomes?. 7287/2020


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Publication history

Received: 21/05/2020

Accepted: 24/06/2020

Online First: 23/11/2020

Published: 09/12/2020

Article revision time: 31 days

Article Online First time: 186 days

Article editing time: 202 days


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