Comparison of endoscopic sphincterotomy techniques after Billroth II gastrectomy using a novel mechanical simulator

Abdelhafez, Mohamed; Frimberger, E; Klare, Peter; Haller, Bernhard; Schmid, Roland M.; Delius, Stefan von

doi:10.1007/s00464-017-5613-y

Cited by 6 publications

(6 citation statements)

References 66 publications

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“…Byun et al[ 9 ], Park et al[ 12 ], Ki et al[ 17 ], and Jang et al[ 15 ] used an esophagogastroduodenoscope. However, Abdelhafez et al[ 19 ] used a colonoscope, and Itoi et al[ 7 ] and Kawamura et al[ 16 ] used a single-balloon enteroscope. Lin et al[ 8 ] used a double-balloon endoscope.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, with the advent of more advanced devices and endoscopic techniques, endoscopic cholangiography and biliary drainage have been increasingly performed in these patients. Although endoscopic retrograde cholangiopancreatography (ERCP) in Billroth II (B-II) patients has been previously reported[ 2 - 19 ], the procedures are difficult, and the techniques and strategies have not been defined.…”

Section: Introductionmentioning

confidence: 99%

“…Among the reports describing the use of a forward-viewing endoscope, some have described the use of esophagogastroduodenoscopy (EGDS)[ 9 , 12 , 15 , 17 , 19 ], and others have described the use of long endoscopes ( e.g ., a colonoscope, single-balloon endoscope, or double-balloon endoscope)[ 7 , 8 , 16 , 19 ]. Therefore, this study aimed to reveal which scope (an esophagogastroduodenoscope or a colonoscope) is appropriate for ERCP in B-II patients.…”

Section: Introductionmentioning

confidence: 99%

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Which scope is appropriate for endoscopic retrograde cholangiopancreatography after Billroth II reconstruction: An esophagogastroduodenoscope or a colonoscope?

Sugimoto

Takagi

Suzuki

et al. 2020

WJGE

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BACKGROUND Recently, with the advent of more advanced devices and endoscopic techniques, endoscopic retrograde cholangiopancreatography (ERCP) in Billroth II (B-II) patients has been increasingly performed. However, the procedures are difficult, and the techniques and strategies have not been defined. AIM To reveal the appropriate scope for ERCP in B-II patients. METHODS Sixty ERCP procedures were performed on B-II patients between June 2005 and May 2018 at Fukushima Medical University Hospital, and in 44 cases, this was the first ERCP procedure performed by esophagogastroduodenoscopy (EGDS) or colonoscopy (CS) after B-II gastrectomy. These cases were divided into two groups: 17 cases of ERCP performed by EGDS (EGDS group) and 27 cases of ERCP performed by CS (CS group). The patient characteristics and ERCP procedures were compared between the EGDS and CS groups. RESULTS The procedural time was significantly shorter in the EGDS group than in the CS group [median (range): 60 (20-100) vs 90 (40-128) min, P value < 0.01]. CS was an independent factor of a longer ERCP procedural time according to the univariate and multivariate analyses (odds ratio: 3.97, 95%CI: 1.05-15.0, P value = 0.04). CONCLUSION Compared to CS, EGDS shortened the procedural time of ERCP in B-II patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Which scope is appropriate for endoscopic retrograde cholangiopancreatography after Billroth II reconstruction: An esophagogastroduodenoscope or a colonoscope?

Sugimoto

Takagi

Suzuki

et al. 2020

WJGE

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“…In a simulator model, needle-knife sphincterotomy guided by a plastic endoprosthesis was more time-consuming, but technically more successful compared to sphincterotomy using a Billroth-II sphincterotome. [ 56 ] High success rates are also reported with a rotatable sphincterotome. [ 57 ] In some cases, use of a forward-viewing endoscope instead of a side-viewing duodenoscope may be preferential.…”

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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“…Supervised simulation practice is widely used for training and has been shown to provide significant benefit in learning endoscopy skills [13 -15]. Different simulators, for example, the ERCP mechanical simulator (EMS) and the X-vision ERCP simulator [15] have been developed for ERCP training [16,17]. The EMS allows trainees to practice basic ERCP maneuvers using real scopes and accessories with simulated fluoroscopy [18].…”

Section: Introductionmentioning

confidence: 99%

Impact of mechanical simulator practice on clinical ERCP performance by novice surgical trainees: a randomized controlled trial

et al. 2020

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Background Lack of forward-viewing endoscopy experience impairs training in endoscopic retrograde cholangiopancreatography (ERCP). We evaluated the effect of ERCP mechanical simulator (EMS) practice on ERCP performance by surgical trainees. Patients and methods 12 surgical trainees without endoscopy experience were randomly allocated to non-EMS (n = 6) programs or to EMS (n = 6) programs with coaching and 20 hours of supervised EMS practice. All trainees then received supervised hands-on clinical ERCP training. Trainers provided verbal instructions and hands-on assistance, and took over if cannulation was not achieved by 20 minutes. Blinded trainers rated clinical performance. Results Each group performed 150 clinical ERCPs. Biliary cannulation success was significantly higher in the EMS vs. the non-EMS group (P = 0.006), with shorter mean times (in minutes) for intubation, cannulation, and completion (all P < 0.001). EMS trainees showed a significantly better mean performance score (P = 0.006). In multivariate analysis, after adjusting for case sequence, CBD stone, complexity, and EMS training, the effect of EMS practice on odds for successful cannulation remained highly significant (odds ratio [OR] 2.10 [95 %CI 1.46 – 3.01]). At 6 months EMS trainees still had better cannulation success vs. non-EMS controls (P = 0.045); no difference was observed after 1 year. Conclusions EMS practice shortens the ERCP early learning curve of inexperienced surgical trainees, improves clinical success in selective biliary cannulation, and may reduce complications.

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Comparison of endoscopic sphincterotomy techniques after Billroth II gastrectomy using a novel mechanical simulator

Abstract: In an ex vivo model for EST in B II gastrectomy needle-knife EST guided by endoprosthesis achieved superior ratings in comparison to the use of a BII sphincterotome, although it was more time-consuming. A standard sphincterotome should not be used for such a procedure.

Cited by 6 publications

References 66 publications

Which scope is appropriate for endoscopic retrograde cholangiopancreatography after Billroth II reconstruction: An esophagogastroduodenoscope or a colonoscope?

Which scope is appropriate for endoscopic retrograde cholangiopancreatography after Billroth II reconstruction: An esophagogastroduodenoscope or a colonoscope?

Controversies in ERCP: Technical aspects

Impact of mechanical simulator practice on clinical ERCP performance by novice surgical trainees: a randomized controlled trial

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