Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 30 May 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy 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

 30 May 2016 
Challenges for direct-acting antivirals in Hep C
 30 May 2016 
Endoscopic indices for disease activity in ulcerative colitis
 30 May 2016 
Colonoscopy reimbursement reduction in practice
 27 May 2016 
Obstructive sleep apnea and NASH
 27 May 2016 
Risk stratification in acute upper GI bleeding
 27 May 2016 
Hepatocellular carcinoma in chronic Hep B patients
 26 May 2016 
Education booklet for colonoscopy bowel preparation
 26 May 2016 
Uncomplicated diverticulitis in outpatients
 26 May 2016 
Direct-acting antivirals in Hep C cirrhosis
 25 May 2016 
Preventing NSAID-associated GI toxicity
 25 May 2016 
Recurrence of Barrett’s after successful endoscopic therapy
 25 May 2016 
PPIs and NSAID-induced small bowel injury
 24 May 2016 
Fecal inflammatory markers in Crohn's
 24 May 2016 
Depression and IBD recurrence
 24 May 2016 
New therapies for NASH
 23 May 2016 
Risk factors for peptic ulcer bleeding outcomes
 23 May 2016 
Liver transplantation for hepatocellular carcinoma
 23 May 2016 
Cancer after colectomy in IBD
 20 May 2016 
Biomarker for colorectal cancer diagnosis
 20 May 2016 
Prognostic score for hepatic venous outflow obstruction
 20 May 2016 
Treatment for uncomplicated acute diverticulitis
 19 May 2016 
Probiotics and H. pylori eradication
 19 May 2016 
Impaired skeletal health in atrophic gastritis
 19 May 2016 
Predicting outcome in ulcerative colitis
 18 May 2016 
Erectile dysfunction in IBD
 18 May 2016 
Acute GERD and esophageal histologic changes
 18 May 2016 
Surgical fundoplication for GERD 
 17 May 2016 
Mucosal dysbiosis in Crohn's disease
 17 May 2016 
Vitamin D level and clinical status in IBD 
 17 May 2016 
Inpatient costs for IBD and acute pancreatitis
 16 May 2016 
Outcomes of postcolonoscopy colorectal cancers
 16 May 2016 
Therapy for Crohn's in a Medicaid population
 16 May 2016 
C. difficile in ulcerative colitis patients
 13 May 2016 
Parkinson's disease and IBD
 13 May 2016 
Inactivated oral cholera vaccine
 13 May 2016 
Non-traditional heart disease risk factors in NAFLD
 12 May 2016 
Gestational diabetes mellitus and NAFLD
 12 May 2016 
Impact of Crohn's in the USA
 12 May 2016 
Ozanimod induction and ulcerative colitis
 11 May 2016 
Anti-TNF discontinuation in IBD
 11 May 2016 
Prognosis after colorectal cancer resection
 11 May 2016 
Age and disease presentation with Crohn's disease
 10 May 2016 
Noninvasive test for IBD
 10 May 2016 
Gluten-free diet in patients with IBS-diarrhea
 10 May 2016 
Digital health for gastroenterology
 09 May 2016 
Diarrheal infections in adults
 09 May 2016 
Quality improvement initiative and readmission for cirrhosis
 09 May 2016 
Coffee or tea and the risk of Barrett's
 06 May 2016 
Risk factors in peptic ulcer bleeding
 06 May 2016 
Recurrent pancreatitis after acute pancreatitis
 06 May 2016 
Managing acute lower GI bleeding
 05 May 2016 
Chemoradiotherapy vs chemotherapy for pancreatic cancer
 05 May 2016 
Genetics in early-early-onset IBD
 05 May 2016 
Reductions in quality of screening colonoscopies
 04 May 2016 
Anti-TNF therapy for IBD
 04 May 2016 
Bismuth and H. pylori eradication
 04 May 2016 
Chromoendoscopy vs colonoscopy for dysplasia in colitis
 03 May 2016 
Vedolizumab for IBD
 03 May 2016 
Surgery vs medical therapy for GERD
 03 May 2016 
PPIs and gut microbiota

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us