Feasibility of Cap-Assisted Endoscopic Retrograde Cholangiopancreatography in Patients with Altered Gastrointestinal Anatomy.
- Author:
Ho Seok KI
1
;
Chang Hwan PARK
;
Chung Hwan JUN
;
Seon Young PARK
;
Hyun Soo KIM
;
Sung Kyu CHOI
;
Jong Sun REW
Author Information
- Publication Type:Original Article
- Keywords: Cholangiopancreatography, endoscopic retrograde; Cap; Billroth II gastrectomy
- MeSH: Adult; Aged; Aged, 80 and over; Cholangiopancreatography, Endoscopic Retrograde/*methods; Duodenostomy/methods; Feasibility Studies; Female; Gastrectomy/methods; Gastric Bypass/methods; Gastrointestinal Tract/*abnormalities; Humans; Male; Middle Aged; Treatment Outcome
- From:Gut and Liver 2015;9(1):109-112
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Endoscopic retrograde cholangiopancreatography (ERCP) is technically challenging in patients with altered gastrointestinal (GI) anatomy. We evaluated the feasibility of cap-assisted ERCP in patients with altered GI anatomy. METHODS: The outcome of ERCP procedures (n=136) was analyzed in 78 patients with Billroth II (B-II) gastrectomy (n=72), Roux-en-Y total gastrectomy (n=4), and hepaticoduodenostomy (n=2). The intubation rate for reaching the papilla of Vater (POV), deep biliary cannulation rate, therapeutic interventions and procedure-related complications were analyzed. All of the procedures were conducted using a cap-fitted forward-viewing endoscope. RESULTS: The rate of access to the POV was 97.1% (132/136). In cases with successful access, selective biliary cannulation was achieved in 98.5% (130/132) of the patients. The successful biliary cannulation rates were 100% (125/125) for B-II gastrectomy, 50% (2/4) for Roux-en-Y gastrectomy and 100% (3/3) for hepaticoduodenostomy. After selective biliary cannulation, therapeutic interventions, including stone extraction (n=57), sphincterotomy (n=54), stent placement (n=37), nasobiliary drainage (n=20), endoscopic papillary balloon dilatation (n=7) and mechanical lithotripsy (n=15), were performed successfully. The procedure-related complication rate was 8.8% (12/136), including immediate bleeding (5.9%, 8/136), pancreatitis (2.2%, 3/136), and perforation (0.7%, 1/136). There were no procedure-related deaths. CONCLUSIONS: Cap-assisted ERCP is efficient and safe in patients with altered GI anatomy.
