Laparoscopic-Assisted ERCP and EUS in Patients With Prior Roux-en-Y Gastric Bypass Surgery: A Dual-Center Case Series Experience

Bowman, Erik; Guda, Nalini M.; Benson, Mark; Pfau, Patrick R.; Soni, Anurag; Garren, Michael; Greenberg, Jacob A.; Gopal, Deepak V.

doi:10.14309/00000434-201410002-00265

Cited by 5 publications

(5 citation statements)

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“…Overall, four studies [15][16][17]35] provided data on EDGE, 18 studies [11,33,[36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51] provided data on LA-ERCP, and five studies [35,44,49,52,53] provided information on BE-ERCP for our analysis.…”

Section: Search Results and Population Characteristicsmentioning

confidence: 99%

EDGE in Roux-en-Y gastric bypass: How does it compare to laparoscopy-assisted and balloon enteroscopy ERCP: a systematic review and meta-analysis

et al. 2020

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Background and study aims Endoscopic ultrasound-directed transgastric ERCP (EDGE) is a new endoscopic procedure to perform ERCP in Roux-en-y gastric bypass (RYGB) patients. The aim of this study was to conduct a systematic review and meta-analysis to evaluate technical success, clinical success and adverse effects of EDGE and compare it to laparoscopic ERCP (LA-ERCP) and balloon ERCP (BE-ERCP). Patients and methods We conducted a comprehensive search of several databases and conference proceedings including PubMed, EMBASE, Google-Scholar, LILACS, SCOPUS, and Web of Science databases to identify studies reporting on EDGE, LA-ERCP, and BE-ERCP. The primary outcome was to evaluate technical and clinical success of all three procedures and the secondary analysis focused on calculating the pooled rate of all adverse events (AEs), along with the commonly reported AE subtypes. Results Twenty-four studies on 1268 patients were included in our analysis with the majority of the population being males with mean age 53.72 years. Pooled rates of technical and clinical success with EDGE wer 95.5 % and 95.9 %, with LA-ERCP were 95.3 % and 92.9 % and were BE-ERCP were 71.4 % and 58.7 %, respectively. Pooled rates of all AEs with EDGE were 21.9 %, with LA-ERCP 17.4 % and with BE-ERCP 8.4 %. Stent migration was the most common AE with EDGE with 13.3 % followed by bleeding with 6.6 %. Conclusion Our meta-analysis demonstrated that the technical and clinical success of EDGE procedure is better than BE-ERCP and comparable to that of LA-ERCP in RYGB patients. EDGE also has a similar safety profile as compared to LA-ERCP but has higher AE rate as compared to BE-ERCP.

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Section: Search Results and Population Characteristicsmentioning

confidence: 99%

EDGE in Roux-en-Y gastric bypass: How does it compare to laparoscopy-assisted and balloon enteroscopy ERCP: a systematic review and meta-analysis

et al. 2020

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“…The feasibility of LA-ERCP has been reported from a few single-center case series, with reported success rate ranging from 80% to 100% and adverse events rate ranging from 0% to 30% 6,7,[23][24][25][27][28][29][30][31][32] . These reports are limited by small sample size and heterogeneous definitions of procedure success and adverse events.…”

Section: Discussionmentioning

confidence: 99%

Multicenter evaluation of the clinical utility of laparoscopy-assisted ERCP in patients with Roux-en-Y gastric bypass

Abbas¹,

Strong²,

Diehl³

et al. 2018

Gastrointestinal Endoscopy

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“…Image-guided percutaneous biopsy may also be attempted. Surgical options include laparoscopic assisted ERCP (LAERCP) (23) and laparoscopically assisted EUS (LAEUS) or a combination of both (24). The decision to proceed with surgery in our patient was based on suspicious imaging findings and endorsed by multidisciplinary board.…”

Section: Discussionmentioning

confidence: 99%

Pancreaticoduodenectomy after Roux-en-Y Gastric Bypass: a novel reconstruction technique

Mak¹,

Shelat²

2022

Transl Gastroenterol Hepatol

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BackgroundThe obesity epidemic continues to increase around the world with its attendant complications of metabolic syndrome and increased risk of malignancies (1), including pancreatic malignancy (2,3). The Roux-en-Y gastric bypass (RYGB) effectively treats obesity and its associated morbidities including metabolic syndrome (4). RYGB creates a gastric pouch with alimentary limb, as well as a biliopancreatic (BP) limb that joins the alimentary limb to form a common channel. Thus, it has both restrictive and mal-absorptive components. Patients with a mass in the head of pancreas are recommended pancreaticoduodenectomy (PD) for suspected malignancy (5). As bariatric surgery is increasingly adopted in recent years (6), more reports of PD following RYGB are published. Post-surgical adhesions and altered anatomy following RYGB poses not only a diagnostic challenge by making endoscopy difficult, but also unique challenge of reconstruction following PD. There are many different techniques of reconstruction proposed. Here we describe a patient where the remnant BP limb was used for a venting anterior gastrojejunostomy. The pancreaticojejunostomy and hepaticojejunostomy was created with a new loop of jejunum and a new distal jejunojejunostomy was performed. MethodsA 59-year-old male presented with painless obstructive jaundice of one week's duration. He had a history of RYGB

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Laparoscopic-Assisted ERCP and EUS in Patients With Prior Roux-en-Y Gastric Bypass Surgery: A Dual-Center Case Series Experience

Cited by 5 publications

References 0 publications

EDGE in Roux-en-Y gastric bypass: How does it compare to laparoscopy-assisted and balloon enteroscopy ERCP: a systematic review and meta-analysis

EDGE in Roux-en-Y gastric bypass: How does it compare to laparoscopy-assisted and balloon enteroscopy ERCP: a systematic review and meta-analysis

Multicenter evaluation of the clinical utility of laparoscopy-assisted ERCP in patients with Roux-en-Y gastric bypass

Pancreaticoduodenectomy after Roux-en-Y Gastric Bypass: a novel reconstruction technique

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