Masaaki Shimatani1, Hisashi Hatanaka2, Hirofumi Kogure3, Koichiro Tsutsumi4, Hiroki Kawashima5, Keiji Hanada6, Tomoki Matsuda7, Tomoki Fujita8, Makoto Takaoka1, Tomonori Yano2, Atsuo Yamada3, Hironari Kato4, Kazuichi Okazaki1, Hironori Yamamoto2, Hideki Ishikawa9, Kentaro Sugano2. 1. The Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University, Osaka, Japan. 2. Department of Medicine, Division of Gastroenterology, Jichi Medical University, Tochigi, Japan. 3. Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 4. Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan. 5. Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan. 6. Department of Gastroenterology, Onomichi General Hospital, Hiroshima, Japan. 7. Digestive Endoscopy Center, Sendai Kousei Hospital, Sendai, Japan. 8. Center for Gastroenterology, Otaru Ekisaikai Hospital, Hokkaido, Japan. 9. Department of Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Abstract
OBJECTIVES: To evaluate the utility and safety of a short-type double-balloon endoscope (DBE) in the treatment of biliary disease in patients with surgically altered gastrointestinal (GI) anatomy. METHODS: This study was conducted as a multicenter, single-arm, prospective trial at five tertiary academic care centers and three community-based hospitals in Japan. Consecutive patients with biliary disease with altered GI anatomy were prospectively included in this study. RESULTS: A total of 311 patients underwent double-balloon endoscopic retrograde cholangiography (ERC). The success rate of reaching the target site, the primary end point, was 97.7% (95% confidence interval (CI): 95.4-99.1). The success rate of biliary cannulation and contrast injection of the targeted duct, the secondary end point, was 96.4% (95% CI: 93.6-98.2), and the therapeutic success rate was 97.9% (95% CI: 95.4-99.2). Adverse events occurred in 33 patients (10.6%, 95% CI: 7.1-14.0) and were managed conservatively in all patients with the exception of 1 in whom a perforation developed, requiring emergency surgery. CONCLUSIONS: ERC using a short-type DBE resulted in an excellent therapeutic success rate and a low rate of adverse events. This treatment can be a first-line treatment for biliary disease in patients with surgically altered GI anatomy.
OBJECTIVES: To evaluate the utility and safety of a short-type double-balloon endoscope (DBE) in the treatment of biliary disease in patients with surgically altered gastrointestinal (GI) anatomy. METHODS: This study was conducted as a multicenter, single-arm, prospective trial at five tertiary academic care centers and three community-based hospitals in Japan. Consecutive patients with biliary disease with altered GI anatomy were prospectively included in this study. RESULTS: A total of 311 patients underwent double-balloon endoscopic retrograde cholangiography (ERC). The success rate of reaching the target site, the primary end point, was 97.7% (95% confidence interval (CI): 95.4-99.1). The success rate of biliary cannulation and contrast injection of the targeted duct, the secondary end point, was 96.4% (95% CI: 93.6-98.2), and the therapeutic success rate was 97.9% (95% CI: 95.4-99.2). Adverse events occurred in 33 patients (10.6%, 95% CI: 7.1-14.0) and were managed conservatively in all patients with the exception of 1 in whom a perforation developed, requiring emergency surgery. CONCLUSIONS: ERC using a short-type DBE resulted in an excellent therapeutic success rate and a low rate of adverse events. This treatment can be a first-line treatment for biliary disease in patients with surgically altered GI anatomy.
Authors: H Yamamoto; Y Sekine; Y Sato; T Higashizawa; T Miyata; S Iino; K Ido; K Sugano Journal: Gastrointest Endosc Date: 2001-02 Impact factor: 9.427
Authors: Klaus Mönkemüller; Lucia C Fry; Michael Bellutti; Helmut Neumann; Peter Malfertheiner Journal: Surg Endosc Date: 2008-12-06 Impact factor: 4.584
Authors: Harry Martin; Tareq El Menabawey; Orla Webster; Constantinos Parisinos; Michael Chapman; Stephen P Pereira; Gavin Johnson; George Webster Journal: Frontline Gastroenterol Date: 2021-02-24