1. Diagnostic and Therapeutic Endoscopic Retrograde Cholangiography Using a Short-Type Double-Balloon Endoscope in Patients With Altered Gastrointestinal Anatomy: A Multicenter Prospective Study in Japan.
- Author
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Shimatani M, Hatanaka H, Kogure H, Tsutsumi K, Kawashima H, Hanada K, Matsuda T, Fujita T, Takaoka M, Yano T, Yamada A, Kato H, Okazaki K, Yamamoto H, Ishikawa H, and Sugano K
- Subjects
- Aged, Aged, 80 and over, Biliary Tract Diseases diagnostic imaging, Biliary Tract Diseases surgery, Cholangitis surgery, Cholangitis therapy, Cholelithiasis surgery, Duodenal Neoplasms surgery, Female, Gastric Bypass, Humans, Japan, Jaundice, Obstructive surgery, Male, Middle Aged, Pancreatic Neoplasms surgery, Prospective Studies, Plastic Surgery Procedures, Stomach Neoplasms surgery, Biliary Tract Surgical Procedures, Cholangiopancreatography, Endoscopic Retrograde instrumentation, Cholangiopancreatography, Endoscopic Retrograde methods, Cholangitis diagnostic imaging, Cholelithiasis diagnostic imaging, Digestive System Surgical Procedures, Double-Balloon Enteroscopy instrumentation, Jaundice, Obstructive diagnostic imaging
- 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.
- Published
- 2016
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