Spiral enteroscopy-assisted ERCP in bariatric-length Roux-en-Y anatomy: a large single-center series and review of the literature (with video)

Gastrointestinal Endoscopy
Mohammad F AliStavros N Stavropoulos

Abstract

Deep enteroscopy-assisted ERCP (DEA-ERCP) in post-bariatric Roux-en-Y (RY) anatomy is challenging. Laparoscopy-assisted ERCP (LA-ERCP) and EUS-directed transgastric ERCP (EDGE) are technically easier and faster but are more invasive and morbid procedures. Therefore, we have used DEA-ERCP as our first-line approach, reserving EDGE and LA-ERCP for cases in which adjunctive techniques that cannot be performed through an enteroscope are required (eg, EUS-FNA, sleeve sphincter of Oddi manometry), or DEA-ERCP failures. The 2 main methods for DEA-ERCP are balloon- and spirus-assisted. Current literature on spiral enteroscopy ERCP (SE-ERCP) in bariatric RY anatomy is scant with low success rates reported. Our center has nearly exclusively used SE-ERCP for bariatric patients. Here, we report one of the largest such series to date. This is a retrospective cohort study of consecutive patients with bariatric-length RY anatomy who had SE-ERCP from December 2009 to October 2016 at a tertiary care center, by one operator (S.N.S.). Primary outcomes included success at reaching the papilla, cannulation success, success of desired therapeutic intervention, and overall SE-ERCP success. Thirty-five SE-ERCPs were performed (28 in bariatric RY gastr...Continue Reading

Citations

Jul 26, 2019·World Journal of Gastroenterology : WJG·Chonlada KrutsriWasaburo Koizumi
Apr 14, 2021·International Journal of Surgery Case Reports·A KleinwortA Glitsch
May 14, 2021·The American Journal of Gastroenterology·Monique T Barakat, Douglas G Adler
Aug 15, 2021·World Journal of Surgery·Ko IkegameMasanori Terashima
Apr 29, 2020·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Andrew D WisneskiCarlos U Corvera

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