Balloon Enteroscopy-Assisted Endoscopic Retrograde Cholangiopancreatography for the Treatment of Common Bile Duct Stones in Patients with Roux-en-Y Gastrectomy: Outcomes and Factors Affecting Complete Stone Extraction

Journal of Clinical Medicine

卷:10

Taisuke Obata¹  Hiroyuki Okada¹  Shigeru Horiguchi¹  Hironari Kato¹  Tatsuhiro Yamazaki¹  Yuki Fujii¹  Koichiro Tsutsumi¹  Kazuyuki Matsumoto¹  Akihiro Matsumi¹  Toru Ueki²  Tsuneyoshi Ogawa²  Kengo Yasugi²  Ryuta Takenaka³  Kazuya Miyamoto³ 

[1] Department of Gastroenterology, Okayama University Hospital, Okayama 7008558, Japan;

[2] Department of Internal Medicine, Fukuyama City Hospital, Fukuyama 7218511, Japan;

[3] Department of Internal Medicine, Tsuyama Chuo Hospital, Okayama 7080841, Japan;

关键词: bile duct stone;    endoscopic retrograde cholangiography;    Roux-en-Y anastomosis;    short-type balloon enteroscopy;    complete stone removal;    gastrectomy;   

DOI  :  10.3390/jcm10153314

来源: DOAJ

【 摘 要 】

Background: Endoscopic retrograde cholangiopancreatography (ERCP) for extraction of common bile duct (CBD) stones in patients with Roux-en-Y gastrectomy (RYG) remains technically challenging. Methods: Seventy-nine RYG patients (median 79 years old) underwent short-type double-balloon enteroscopy-assisted ERCP (sDBE-ERCP) for CBD stones at three referral hospitals from 2011–2020. We retrospectively investigated the treatment outcomes and potential factors affecting complete stone extraction. Results: The initial success rates of reaching the papilla of Vater, biliary cannulation, and biliary intervention, including complete stone extraction or biliary stent placement, were 92%, 81%, and 78%, respectively. Of 57 patients with attempted stone extraction, complete stone extraction was successful in 74% for the first session and ultimately in 88%. The adverse events rate was 5%. The multivariate analysis indicated that the largest CBD diameter ≥ 14 mm (odds ratio (OR), 0.04; 95% confidence interval (CI), 0.01–0.58; p = 0.018) and retroflex position (OR, 6.43; 95% CI, 1.12–36.81; p = 0.037) were independent predictive factors affecting complete stone extraction achievement. Conclusions: Therapeutic sDBE-ERCP for CBD stones in a relatively elderly RYG cohort, was effective and safe. A larger CBD diameter negatively affected complete stone extraction, but using the retroflex position may be useful for achieving complete stone clearance.

【 授权许可】

Unknown