Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

ERCP with the overtube-assisted enteroscopy technique

This month's issue of Endoscopy compared the efficacy and safety of overtube-assisted enteroscopy-ERCP in patients with different configurations of upper gastrointestinal anatomy.

News image

Overtube-assisted enteroscopy techniques have increased the ability to perform endoscopic retrograde cholangiopancreatography (ERCP) in patients with altered upper gastrointestinal anatomy, such as Roux-en-Y gastric bypass.

Dr Matthew Skinner and colleagues compared the efficacy and safety of overtube-assisted enteroscopy-ERCP in patients with different configurations of upper gastrointestinal anatomy.

A systematic review was performed following a literature search for papers published between 1966 and August 2013.

The team searched MEDLINE, Embase, Cochrane library, and Scopus.

The researchers analyzed diagnostic and therapeutic success rates, cannulation success rate, ERCP success rate, type of enteroscopy, types of intervention, complications.

A total of 23 relevant reports on overtube-assisted enteroscopy procedures, including single-balloon, double-balloon, and spiral enteroscopy, were analyzed.

Overall ERCP success for all attempts was approximately 74%
Endoscopy

Studies included a total of 945 procedures in 679 patients who had a variety of postsurgical upper gastrointestinal anatomical configurations.

The team noted that among patients who underwent Roux-en-Y with gastric bypass, endoscopic success was 80% and ERCP success was 70%.

In patients who had undergone a Roux-en-Y with either a pancreaticoduodenectomy, pylorus-preserving pancreaticoduodenectomy, or hepaticojejunostomy, endoscopic success was 85% and ERCP success was 76%.

In patients who had undergone a Billroth II procedure, endoscopic success was 96% and ERCP success was 90%.

The research team noted that in patients with native papilla who underwent successful endoscopy, cannulation was successful in 90% of patients compared with 92% in patients with an anastomosis.

Overall ERCP success for all attempts was approximately 74%.

Interventions included sphincterotomy, pre-cut papillotomy, anastomotic stricturoplasty, stone removal, stent insertion, stent replacement, and balloon dilation of stenotic anastomosis.

The researchers found 32 major complications among the 945 procedures.

Dr Skinner's team concludes, "Both endoscopic and ERCP success rates were highest in patients with Billroth II anatomy, followed by those with pancreaticoduodenectomy and Roux-en-Y hepaticojejunostomy."

"The lowest success rates were in patients with Roux-en-Y gastric bypass."

"Cannulation rates appeared to be equivalent in patients with both native papilla and biliary-enteric or pancreaticoenteric anastomoses."

"The diagnostic and therapeutic potential of balloon-assisted ERCP were high and the adverse event rate was low."

Endoscopy 2014; 46(07): 560-572
18 July 2014

Go to top of page Email this page Email this page to a colleague

 21 April 2015

Advanced search
 21 April 2015 
Risk factors of postpartum bowel changes
 21 April 2015 
Tracking colonoscopy surveillance intervals
 21 April 2015 
PPI increases risk of cryptogenic liver abscess
 20 April 2015 
IBS after traveller's diarhea
 20 April 2015 
Adherence to Hep C treatments
 20 April 2015 
Economic impact of C. diff infection
 17 April 2015 
Synchronous colorectal advanced neoplasia
 17 April 2015 
PNPLA3 polymorphisms and NAFLD risk
 17 April 2015 
MELD score and colorectal resection
 16 April 2015 
Bleeding risk in colonic diverticulosis
 16 April 2015 
Minority use of high-volume hospitals for colorectal cancer
 16 April 2015 
Sleep and IBD
 15 April 2015 
Treatment of hepatocellular carcinoma
 15 April 2015 
Score predicts malignant bile duct obstruction
 15 April 2015 
Increased risk of Barrett esophagus
 14 April 2015 
Improving colorectal cancer screening uptake
 14 April 2015 
Colorectal cancer presenting under the age of 50
 14 April 2015 
Functional constipation vs constipation predominant IBS
 13 April 2015 
CRP and acute diverticulitis
 13 April 2015 
Immune based treatments for HCC
 13 April 2015 
Fecal transplant for C. difficile
 10 April 2015 
Hypnotherapy for IBS
 10 April 2015 
Adjuvant therapy after rectal cancer
 10 April 2015 
Viral outcomes in HCV infection
 09 April 2015 
Male IBD patients wishing to conceive
 09 April 2015 
Screening programs based on the fecal immunochemical test
 09 April 2015 
Management of esophageal food impaction
 08 April 2015 
Nonceliac gluten sensitivity
 08 April 2015 
Ambulatory hemorrhoidal surgery
 08 April 2015 
Iron fortification and gut inflammation
 07 April 2015 
Endoscopic managements of GI bleeds
 07 April 2015 
Interventions for eosinophilic esophagitis
 07 April 2015 
Treatment of Hep C virus
 06 April 2015 
Treatment for rectal cancer
 06 April 2015 
Risk stratifying Barrett's esophagus
 06 April 2015 
Cost-effectiveness of HCV
 03 April 2015 
Predicting advanced cancer in Barrett's
 03 April 2015 
Vitamin D deficiency and Hep B outcomes
 03 April 2015 
Hepatocellular carcinoma surveillance in cirrhosis
 02 April 2015 
Physical activity and NAFLD
 02 April 2015 
Genetic risk for Crohn's disease
 02 April 2015 
EUS for detection of pancreatic neuroendocrine tumors
 01 April 2015 
Analysis of liver fibrosis
 01 April 2015 
Obeticholic acid in primary biliary cirrhosis
 01 April 2015 
Mortality rates for upper GI bleeds
 31 March 2015 
HCV-HIV co-infection combination therapy
 31 March 2015 
Placement of nasoenteral feeding tubes
 31 March 2015 
Hepatic fat and gallbladder polyps
 30 March 2015 
Minimally invasive approach in colorectal procedures
 30 March 2015 
Prevalence of IBD in USA residents of Indian ancestry
 30 March 2015 
Treatment of pediatric IBD
 27 March 2015 
Screening for fecal incontinence
 27 March 2015 
Deep remission in Crohn's disease
 27 March 2015 
Sexual functioning in IBD
 26 March 2015 
Antimicrobial therapy in cirrhosis with spontaneous bacterial peritonitis
 26 March 2015 
Metformin as a chemopreventive agent for Barrett's
 26 March 2015 
Survival of untreated hepatocellular carcinoma
 25 March 2015 
Genetics and Crohn's disease
 25 March 2015 
Mortality in Barrett’s–related T1 esophageal adenocarcinoma
 25 March 2015 
Cytomegalovirus and IBD

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us