A comparative study of side-viewing duodenoscope and forward-viewing gastroscope to perform endoscopic retrograde cholangiopancreatography in patients with Billroth II gastrectomy

Çoşkun, Orhan; Ödemiş, Bülent

doi:10.1007/s00464-020-07904-x

Cited by 6 publications

(7 citation statements)

References 21 publications

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“…When considering all patients, duodenoscope had a higher adverse events rate (8% [1‒15] vs. 0% [0–0.5], p = 0.147) namely perforation ( p = 1.0) and hemorrhage rate ( p = 1.0), though not statistically significant. Likewise, when considering only the subgroup of patients in which the papilla major was identified and biliary cannulation attempted, duodenoscope had a higher adverse events rate (9% [0–18] vs. 0% [0–1], p = 0.208), though not statistically significant.…”

Section: Resultsmentioning

confidence: 98%

“…While papilla identification and cannulation are thought to be easier with side-viewing duodenoscope; afferent loop intubation and reaching the papilla are easier with forward-viewing gastroscope with lower risk of perforation [ 1 , 4 , 10 ]. Regarding cannulation, different cannulation techniques have been described: standard cannulas, conventional sphincterotome [ 3 , 8 , 11 ], needle-knife [ 8 , 11 ], and rotatable or dedicated inverted sphincterotome [ 11 , 12 ]. However, the optimal approach, namely the type of endoscope and sphincter management, has yet to be defined.…”

Section: Introductionmentioning

confidence: 99%

“…However, the optimal approach, namely the type of endoscope and sphincter management, has yet to be defined. Indeed, comparative studies are scarce [ 10 , 11 ] and the majority of the studies published are retrospective, without prospective databases, and single arm [ 1 , 3 , 4 , 7 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Side-Viewing Duodenoscope versus Forward-Viewing Gastroscope for Endoscopic Retrograde Cholangiopancreatography in Billroth II Gastrectomy Patients

Sá

Chaves

Sousa³

et al. 2022

GE Port J Gastroenterol

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Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) in patients with Billroth II gastrectomy is still a challenging procedure. The optimal approach, namely the type of endoscope and sphincter management, has yet to be defined. Aim: To compare the efficacy and safety of forward-viewing gastroscope and the side-viewing duodenoscope in ERCP of patients with Billroth II gastrectomy. Methods: We conducted a retrospective, single-center cohort study of consecutive patients with Billroth II gastrectomy submitted to ERCP in an expert center for ERCP between 2005 and 2021. The outcomes assessed were: papilla identification, deep biliary cannulation, and adverse events (AEs). Multivariate analysis was performed to evaluate potential associations and predictors of the main outcomes. Results: We included 83 patients with a median age of 73 (IQR 65–81) years. ERCP was performed using side-viewing duodenoscope in 52 and forward-viewing gastroscope in 31 patients. Patients’ characteristics were similar in the two groups. The global rate of papilla identification was 66% (n = 55). The rate of deep cannulation was 58% considering all patients and 87% in the subgroup of patients in which the papilla major was identified. Cannulation was performed with standard methods in 65% of cases and with needle-knife fistulotomy in 35%. AEs occurred in 4 patients. There was no difference between duodenoscope and gastroscope in papilla identification (64% [95% CI: 51–77] vs. 71% [55–87]). Although not statistically significant, duodenoscope had a lower deep cannulation rate when considering all patients (52% [15–39] vs. 68% [7–35]) and a higher AEs rate (8% [1–15] vs. 0% [0–1]). In a multivariate analysis, the use of gastroscope significantly increased the deep cannulation rate (OR = 152.62 [2.5–9,283.6]). Conclusion: This study demonstrates that forward-viewing gastroscope is at least as effective and safe as side-viewing duodenoscope for ERCP in patients with Billroth II gastrectomy. Moreover, our study showed that gastroscope is an independent predictor of successful cannulation.

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Section: Resultsmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Side-Viewing Duodenoscope versus Forward-Viewing Gastroscope for Endoscopic Retrograde Cholangiopancreatography in Billroth II Gastrectomy Patients

Sá

Chaves

Sousa³

et al. 2022

GE Port J Gastroenterol

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“…[ 57 ] In some cases, use of a forward-viewing endoscope instead of a side-viewing duodenoscope may be preferential. [ 58 59 60 ] Prospective studies comparing the different techniques are lacking.…”

Section: Endoscopic Sphincterotomy and Confirmation Of Common Bile Du...mentioning

confidence: 99%

Controversies in ERCP: Technical aspects

et al. 2022

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The aim of the series of papers on controversies of biliopancreatic drainage procedures is to discuss pros and cons of the varying clinical practices and techniques in ERCP and EUS for drainage of biliary and pancreatic ducts. While the first part focuses on indications, clinical and imaging prerequisites prior to ERCP, sedation options, post-ERCP pancreatitis prophylaxis, and other related technical topics, the second part discusses specific procedural ERCP techniques including precut techniques and their timing as well as management algorithms. In addition, reviews on controversies in EUS-guided bile duct and pancreatic drainage procedures are under preparation.

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“…The rates of reaching the papilla were 70.7% and 91.1%, respectively ( P = 0.06). Cannulation success rate after reaching the papilla was 100% in the side-viewing duodenoscope group and 90.3% in the forward-viewing endoscope group[ 55 ].…”

Section: Different Approaches For Patients With Altered Anatomymentioning

confidence: 99%

Endoscopic management of difficult common bile duct stones: Where are we now? A comprehensive review

Tringali¹,

Costa²,

Fugazza³

et al. 2021

WJG

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Endoscopic management for difficult common bile duct (CBD) stones still presents a challenge for several reasons, including anatomic anomalies, patients’ individual conditions and stone features. In recent years, variable methods have emerged that have attributed to higher stone removal success rates, reduced cost and lower adverse events. In this review, we outline a stepwise approach in CBD stone management. As first line therapy, endoscopic sphincterotomy and large balloon dilation are recommended, due to a 30%-50% reduction of the use of mechanical lithotripsy. On the other hand, cholangioscopy-assisted lithotripsy has been increasingly reported as an effective and safe alternative technique to mechanical lithotripsy but remains to be reserved in special settings due to limited large-scale evidence. As discussed, findings suggest that management needs to be tailored to the patient’s characteristics and anatomical conditions. Furthermore, we evaluate the management of CBD stones in various surgical altered anatomy (Billroth II, Roux-en-Y and Roux-en-Y gastric bypass). Moreover, we could conclude that cholangioscopy-assisted lithotripsy needs to be evaluated for primary use, rather than following a failed management option. In addition, we discuss the importance of dissecting other techniques, such as the primary use of interventional endoscopic ultrasound for the management of CBD stones when other techniques have failed. In conclusion, we recognize that endoscopic sphincterotomy and large balloon dilation, mechanical lithotripsy and intraductal lithotripsy substantiate an indication to the management of difficult CBD stones, but emerging techniques are in rapid evolution with encouraging results.

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A comparative study of side-viewing duodenoscope and forward-viewing gastroscope to perform endoscopic retrograde cholangiopancreatography in patients with Billroth II gastrectomy

Cited by 6 publications

References 21 publications

Side-Viewing Duodenoscope versus Forward-Viewing Gastroscope for Endoscopic Retrograde Cholangiopancreatography in Billroth II Gastrectomy Patients

Side-Viewing Duodenoscope versus Forward-Viewing Gastroscope for Endoscopic Retrograde Cholangiopancreatography in Billroth II Gastrectomy Patients

Controversies in ERCP: Technical aspects

Endoscopic management of difficult common bile duct stones: Where are we now? A comprehensive review

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