Endoscopy and ERCP in the setting of previous upper GI tract surgery. Part I: Reconstruction without alteration of pancreaticobiliary anatomy

Feitoza, Arnaldo B.; Baron, Todd H.

doi:10.1067/mge.2001.120169

Cited by 76 publications

(52 citation statements)

References 22 publications

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“…2). [1][2][3] In a single tertiary care center study involving 51 Whipple resection patients using a duodenoscope in the majority, an overall 51% technical success rate was demonstrated. Success was significantly higher for biliary indications (84%) than for pancreatic indications (8%).…”

Section: Ercp In Roux-en-y Hepaticojejunostomy Anatomymentioning

confidence: 99%

“…The challenge to reach the papilla could be due to multitude of factors such as the sharply angulated afferent limb entrance, endoscope looping, intra-abdominal postoperative adhesions, and long roux or afferent enteral limbs. [1][2][3][4] To overcome these difficulties, various strategies have been demonstrated to achieve high success rate in these technically challenging ERCPs. In this review we aim to discuss the most commonly encountered surgically altered anatomies requiring non-standard ERCP techniques.…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic retrograde cholangiopancreatography in surgically altered anatomy

Goyal

Kasapoğlu

Thosani

2017

Int J Gastrointest Interv

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Endoscopic retrograde cholangiopancreatography (ERCP) in a surgically altered anatomy is a technically challenging undertaking with variable success and adverse event rates. There are several potential challenges to successfully perform an ERCP in patients with surgically altered anatomy such as identification of afferent limb, accessing and visualization of the papilla, and selective cannulation of the biliary and pancreatic ducts from altered orientation of the papilla. Several strategies to improve the success rate have been recommended by various endoscopy experts. In this review, we discussed the published literature involving various ERCP techniques described for surgically altered anatomies.

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Section: Ercp In Roux-en-y Hepaticojejunostomy Anatomymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Endoscopic retrograde cholangiopancreatography in surgically altered anatomy

Goyal

Kasapoğlu

Thosani

2017

Int J Gastrointest Interv

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“…La anatomía de esta reconstrucción permite la realización de una CPRE convencional en cerca de 25% de los casos (Figura 1) 12 . Junto con lo anterior, en el BGYR hay un alargamiento de las asas aferente y eferente del reconstrucción en Y-de-Roux lo que provoca una mayor difi cultad en la progresión y evaluación endoscópica convencional por vía oral 1 . En 1997, Hintze et al 13 , describieron una tasa 33% de identifi cación de la papila con duodenoscopio convencional en casos de asa eferente corta.…”

Section: Cpre Convencionalunclassified

“…La anastomosis gastrointestinal en Y-de-Roux es una técnica de reconstrucción del tránsito intestinal creada para desviar la secreción biliopancreática e impedir su refl ujo al estómago 1,2 . La pandemia de la obesidad posicionó al bypass gástrico en Y-deRoux (BGYR) como uno de los procedimientos quirúrgicos más empleados para tratar esta enfermedad 3 .…”

Section: Introductionunclassified

“…El éxito técnico de este procedimiento es mayor al 90%, con una morbididad de 5% y mortalidad menor al 1% en centros de referencia 7,8 . El BGYR implica la exclusión duodenal y de la papila mayor del tránsito normal del tubo digestivo, prácticamente impidiendo el acceso y por tanto, el tratamiento endoscópico de la litiasis de la vía biliar principal empleando equipamientos convencionales debido a la mayor distancia y tortuosidad de las asas yeyunales 1,9,10 . En esta situación, se ha sugerido el acceso a la papila duodenal mayor a través de un enteroscopio, colonoscopio o duodenoscopio convencional introducido a través de una ostomía 11 .…”

Section: Introductionunclassified

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Colangiopancreatografía retrógrada endoscópica en pacientes con asa en Y-de-Roux

et al. 2012

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Endoscopic retrograde cholangiopancreatography in Roux-en-Y patientsThe reconstruction of the digestive tract with a Roux-en-Y anastomosis has been performed more frequently in the last years mainly due to the overgrowth in the surgical treatment of obesity by gastric bypass in Roux-en-Y. The obesity pandemic is also associated with an increase in both the preoperative and postoperative diagnosis of gallstones in this population. Bearing in mind the greater complexity of endoscopic retrograde cholangiopancreatography in these circumstances, the authors have reviewed the various endoscopic approaches available, evaluating 249 articles published between 1990 and 2010 obtained from Medline, Cochrane and Scielo, excluding case reports and articles outside the specifi c scope of this study. Endoscopic techniques with high success rates include the use of enteroscope, colonoscope, enteral and transgastric access combined with surgery. Even with the technological progress already made, further development of the instruments used will be necessary if greater comfort and safety is to be achieved with this procedure.Key words: Choledocholithiasis (MeSH), Anastomosis, Roux-en-Y (MeSH), Gastric Bypass (MeSH), Cholangiopancreatography, Endoscopic Retrograde (MeSH). ResumenLa reconstrucción del trato digestivo con un asa en Y-de-Roux ha sido más empleada en los últimos años debido principalmente al aumento del tratamiento quirúrgico de la obesidad mediante el bypass gástrico en Y-de-Roux (BGYR). La pandemia de la obesidad se ha asociado a un aumento en la prevalencia de litiasis biliar en esta población, diagnosticada en el estudio preoperatorio y durante el seguimiento postoperatorio. La colangiopancreatografía endoscópica retrógrada (CPRE) posee una mayor complejidad en estas circunstancias donde existe una alteración anatómica que difi culta el acceso a la papila mayor. El objetivo de esta revisión es describir las alternativas de acceso al asa biliopancreática para realizar CPRE en pacientes con un asa en Y-deRoux enfatizando la accesibilidad técnica, los resultados y complicaciones de los procedimientos. Se realizó una búsqueda y revisión de la literatura en las bases de datos: Medline, Cochrane y Scielo. Se evaluaron 249 publicaciones desde 1990 a 2010, en idioma español, inglés y portugués. Fueron excluidos de esta revisión los reportes de casos y publicaciones no atingentes. Las opciones endoscópicas para realizar CPRE en pacientes Rev.

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Hepatobiliary Endoscopy in the Patient with Liver Disease and Altered Anatomy

Amateau

2017

Endoscopy in Liver Disease

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Endoscopy and ERCP in the setting of previous upper GI tract surgery. Part I: Reconstruction without alteration of pancreaticobiliary anatomy

Cited by 76 publications

References 22 publications

Endoscopic retrograde cholangiopancreatography in surgically altered anatomy

Endoscopic retrograde cholangiopancreatography in surgically altered anatomy

Colangiopancreatografía retrógrada endoscópica en pacientes con asa en Y-de-Roux

Hepatobiliary Endoscopy in the Patient with Liver Disease and Altered Anatomy

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