Recent advances in endoscopic retrograde cholangiopancreatography in Billroth II gastrectomy patients: A systematic review

Table 1 Characteristics of the 43 studies included in the systematic review

Study	Study design	No.	Indications for ERCP	Type of endoscope	Sphincter therapy	A-loop intubation, No. (%)	Selective cannulation, No. (%)	Adverse events
Forbes and Cotton[1], 1984	Retrospective cohort	53	N/A	S	EST	45/53 (84.9)	35/45 (77.8)	Bowel perforation (n = 1, 1.9%)
Osnes et al[2], 1986	Retrospective cohort	147	N/A	S	EST	134/147 (91.2)	134/134 (100)	Bowel perforation (n = 1, 0.7%)
								Pancreatitis (n = 1, 0.7%)
								Bleeding (n = 1, 0.7%)
								Mortality (n = 2, 1.4%)
Hintze et al[31], 1997	Retrospective cohort	59	CBD stone	S	EST	54/59 (91.5)	54/54 (100)	Bowel perforation (n = 1, 1.7%)
			Papillary stenosis					Mortality (n = 1, 1.7%)
			Tumor stenosis
			Juxtapapillary diverticulum
Kim et al[3], 1997	Prospective comparative	45	N/A	F (n = 23)	EST±NK	44/45	36/44 (80.0)	Bowel perforation (n = 4, 8.9%)
						(97.8)
				S (n = 22)				Pancreatitis (n = 3, 2.2%)
Lin et al[32], 1999	Retrospective cohort	56	CBD stone	F	EST	43/56 (76.6)	35/43 (81.3)	Bleeding (n = 3, 5.4%)
			CBD dilation
			RUQ pain with cholestasis
Faylona et al[33], 1999	Retrospective cohort	110	Cholangitis (n = 58)	S	EST	2132/185 (71.4)	2122/132 (92.4)	Bowel perforation (n = 11, 5.9%)
			CBD stone (n = 41)					Pancreatitis (n = 1, 0.5%)
			Jaundice (n = 28)
			CBD dilation (n = 19)					Bleeding (n = 3, 1.6%)
			Pancreatitis (n = 9)					Mortality (n = 2, 1.1%)
			Others (n = 30)
Bergman et al[11], 2001	Prospective comparative	34	CBD stone (n = 34)	S	EST/EPBD	N/A	28/34 (82.4)	Bowel perforation (n = 1, 2.9%)
								Pancreatitis (n = 1, 2.9%)
								Bleeding (n = 3, 8.8%)
								Respiratory insufficiency (n = 1, 2.9%)
Swarnkar et al[34], 2005	Retrospective cohort	41	CBD stone (n = 16)	S	EST	242/48 (87.5)	241/42 (97.6)	Bowel perforation (n = 1, 2.1%)
			CBD dilation (n = 9)
			Pancreatitis (n = 4)
			Gastric cancer (n = 3)
			Pancreatic cancer (n = 2)
			Others (n = 7)
								Bleeding (n = 2, 4.2%)
Kikuyama et al[35], 2005	Retrospective cohort	24	CBD stone (n = 14)	AOE	EST	24/24 (100)	22/24 (91.7)	Bowel perforation (n = 1, 4.2%)
			Pancreaticobiliary malignancy (n = 8)					Pancreatitis (n = 1, 4.2%)
								Bleeding (n = 1, 4.2%)
			Others (n = 2)
Ciçek et al[36], 2006	Retrospective cohort	52	CBD stone (n = 27)	S	EST±NK	45/52 (94.2)	43/45 (95.6)	Bowel perforation (n = 6, 11.5%)
			Jaundice (n = 11)					Bleeding (n = 3, 1.6%)
			Pancreatico-biliary malignancy (n = 10)
								(n = 2, 3.8%)
			Bile leakage (n = 2)
			Others (n = 2)
Park et al[37], 2007	Retrospective cohort	10	CBD stone (n = 9)	1F	EST	10/10 (100)	10/10 (100)	None
			CBD stricture (n = 1)
Dolay and Soylu[38], 2008	Retrospective cohort	11		S	EST	11/11 (100)	11/11 (100)	None
Nakahara et al[39], 2009	Retrospective comparative	43	CBD stone (n = 43)	AOE	EST/EPBD±NK	38/43 (88.4)	36/38 (94.7)	None
Koo et al[10], 2009	Retrospective cohort	14	CBD stone (n = 8)	Multiple bending endoscope	EST/EPBD	14/14 (100)	13/14 (92.9)	None
			Biliary pancreatitis (n = 2)
			Pancreatico-biliary malignancy (n = 3)
			Bile leakage after cholecystectomy (n = 1)
Shimatani et al[40], 2009	Retrospective cohort	17	N/A	DBE	EST/EPBD	222/22 (100)	222/22 (100)	None
Kikuyama et al[41], 2009	Retrospective cohort	11	CBD stone (n = 8)	AOE with over tube	EST/EPBD	210/15 (66.7)	210/10 (100)	None
			Pancreatico-biliary malignancy (n = 3)
			Chronic pancreatitis (n = 1)
Lin et al[42], 2010	Retrospective cohort	32	N/A	S (n = 22)	EPBD	30/32 (68.8)	28/30 (93.3)	Bowel perforation (n = 2, 6.3%)
				DBE (n = 8)
Itoi et al[12], 2010	Retrospective cohort	11	CBD stone (n = 11)	F (n = 8)	EST+EPLBD	11/11 (100)	11/11 (100)	None
				S (n = 1)
				AOE (n = 1)
				SBE (n = 1)
Lee et al[30], 2012	Retrospective cohort	13	CBD stone (n = 13)	1F	EPLBD	13/13 (100)	12/13 (92.3)	Bleeding (n = 1, 7.7%)
Byun et al[43], 2012	Retrospective cohort	46	CBD stone (n = 37)	F	EST+EPBD	42/46 (91.3)	42/42 (100)	Bowel perforation (n = 1, 2.2%)
			Pancreatico-biliary malignancy (n = 5)					Pancreatitis (n = 1, 2.2%)
			Benign biliary stricture (n = 4)
Choi et al[44], 2012	Retrospective comparative	26	CBD stone (n = 26)	S (n = 13)	EST±EPBD	26/26 (100)	26/26 (100)	None
				F (n = 13)
Kianicka et al[45], 2012	Retrospective cohort	120	Cholestasis (n = 100)	F	EST	109/120 (90.8)	109/120 (90.8)	Bowel perforation (n = 1, 0.8%)
			Biliary pancreatitis (n = 12)					Pancreatitis (n = 2, 1.7%)
			Acute cholangitis (n = 6)					Bleeding (n = 2, 1.7%)
			Bile leakage (n = 2)
Osoegawa et al[27], 2012	Retrospective cohort	15	N/A	DBE	EST/EPBD±NK	218/19 (94.7)	216/18 (88.9)	Bowel perforation (n = 1, 0.5%)
Sen-Yo et al[46], 2012	Retrospective comparative	65	CBD stone (n = 38)	AOE	EST/EPBD±NK	60/65 (92.3)	60/60 (100)	Bowel perforation (n = 1, 1.5%)
			Pancreatico-biliary malignancy (n = 17)					Pancreatitis (n = 3, 4.6%)
								Cholangitis (n = 2, 3.0%)
			Other malignancy (n = 2)
			Chronic pancreatitis (n = 2)
			Bile leakage (n = 2)
			Others (n = 4)
Jang et al[47], 2013	Retrospective cohort	40	CBD stones (n = 40)	S	EPLBD±NK	40/40 (100)	40/40 (100)	Pancreatitis (n = 2, 5.0%)
Yao et al[9], 2013	Retrospective cohort	46	CBD stone (n = 38)	Dual-lumen gastroscope	EST/EPBD	38/46 (82.6)	38/38 (100)	None
			Biliary stricture (n = 3)
			Pancreatico-biliary malignancy (n = 5)
Kawamura et al[48], 2013	Retrospective comparative	65	CBD stone (n = 49)	F (n = 56)	N/A	61/65 (93.8)	51/61 (83.6)	Bowel perforation (n = 2, 3.1%)
			Pancreatico-biliary malignancy (n = 26)	S (n = 2)				Pancreatitis (n = 4, 6.2%)
				SBE (n = 3)
				Others (n = 4)				Bleeding (n = 1, 1.5%)
			Benign biliary stricture (n = 1)
Kim et al[49], 2014	Retrospective cohort	30	CBD stone (n = 30)	S	EPLBD±EST	30/30 (100)	30/30 (100)	Pancreatitis (n = 2, 6.7%)
								Bleeding (n = 2, 6.7%)
Iwai et al[50], 2014	Retrospective comparative	19	N/A	SBE	N/A	18/19 (95)	18/18 (100)	None
Cheng et al[51], 2015	Retrospective cohort	77	CBD stone (n = 77)	DBE	EPLBD/ EPBD±NK	73/77 (95)	67/73 (92)	Bowel perforation (n = 3, 3.8%)
								Intestinal mucosal tear (n = 2, 2.6%)
Jang et al[52], 2015	Retrospective cohort	36	CBD stone (n = 28)	1F	EPBD± EST	36/36 (100)	32/36 (88.9)	Bowel perforation (n = 3, 8.3%)
			Benign biliary stricture (n = 6)					Pancreatitis ((n = 2, 5.6%)
			Pancreatico-biliary malignancy (n = 1)
			Post-operative bile leakage (n = 1)
Ki et al[53], 2015	Retrospective cohort	72	CBD stone (n = 55)	1F	EST/EPBD	2125/126 (99.2)	2125/125 (100)	Bowel perforation (n = 1, 0.7%)
			Cholangitis (n = 11)
			CBD stricture (n = 7)
			Pancreatico-biliary malignancy (n = 3)
			IHD stone (n = 2)
								Pancreatitis (n = 3, 2.2%)
								Bleeding (n = 8, 5.9%)
Nakahara et al[54], 2015	Retrospective cohort	25	CBD stone (n = 15)	AOE	EST/EPBD	226/30 (86.7)	226/26 (100)	Pancreatitis (n = 1, 3.3%)
			Pancreatico-biliary malignancy (n = 7)
			Chronic pancreatitis (n = 3)
Bove et al[17], 2015	Retrospective cohort	713	CBD stone (n = 365)	S (n = 600)	EST	618/713 (86.7)	580/618 (93.8)	Bowel perforation (n = 22, 3.1%)
				F (n = 18)
			Obstructive jaundice (n = 177)					Pancreatitis (n = 5, 0.7%)
			Acute cholangitis (n = 61)
			Chronic pancreatitis (n = 55)					Bleeding (n = 11, 1.5%)
			Biliary pancreatitis (n = 21)
								Mortality (n = 2, 0.3%)
			Benign biliary stricture (n = 9)
			Others (n = 5)
Wu et al[18], 2016	Retrospective cohort	135	CBD stone/cholangitis	S	EST+EPBD	120/135 (88.8)	117/135 (86.3)	2Bowel perforation (n = 1, 0.7%)
			Benign biliary stricture					Pancreatitis (n = 9, 4.1%)
								Bleeding (n = 2, 0.9%)
Park et al[19], 2016	Retrospective cohort	165	CBD stone (n = 133)	1F	EPBD±NK	151/165	144/151	Bowel perforation (n = 3, 1.8%)
			Benign biliary stricture (n = 21)			(91.5)	(95.4)	Pancreatitis (n = 13, 7.9%)
			Pancreatico-biliary malignancy (n = 11)
								Hyperamylasemia (n = 22, 13.3%)
Wang et al[28], 2016	Retrospective cohort	18	CBD stone (n = 15)	Dual-lumen gastroscope	EST/EPBD	15/18 (83.3)	15/15 (100)	Pancreatitis (n = 2, 11.1%)
			Pancreatico-biliary malignancy (n = 3)					Bleeding (n = 1, 5.6%)
Wang et al[29], 2016	Retrospective cohort	52	CBD stone (n = 38)	C (n = 31)	EST/EPBD±NK	50/52 (96.2)	50/52 (96.2)	Pancreatitis (n = 2, 3.8%)
			Biliary stricture (n = 9)	F (n = 13)				Hyperamylasemia (n = 2, 3.8%)
			Pancreatico-biliary malignancy (n = 5)	S (n = 11)
Shimatani et al[25], 2016	Prospective cohort	26	Cholangitis (n = 13)	DBE	EST	25/26 (96.2)	25/25 (100)	Bowel perforation (n = 2, 7.7%)
			Hepatobiliary disorder (n = 4)					Pancreatitis (n = 5, 19.2%)
			Obstructive jaundice (n = 4)					Cholangitis (n = 1, 3.8%)
			CBD stone (n = 2)
								Aspiration pneumonia (n = 1, 3.8%)
			Others (n = 3)
Shimatani et al[55], 2017	Retrospective cohort	11	CBD stone (n = 7)	DBE	EST	11/11 (100)	11/11 (100)	None
			Obstructive jaundice (n = 2)
			Others (n = 2)
Yane et al[26], 2017	Retrospective cohort	20	CBD stone	SBE	N/A	20/20 (100)	19/20 (95)	Bowel perforation (n = 2, 1.0%)
			Bile duct stricture					Pancreatitis (n = 3, 1.5%)
			Aanstomosis site stricture					Cholangitis (n = 4, 2.0%)
								Cholecystitis (n = 1, 0.5%)
Li et al[56], 2017	Retrospective cohort	49	CBD stone (n = 49)	S	EPBD	N/A	42/49 (85.7)	Pancreatitis (n = 3, 6.1%)
Han et al[57], 2018	Retrospective cohort	15	CBD stone (n = 15)	1F	EST/EPBD±NK	15/15 (100)	15/15 (100)	Pancreatitis (n = 1, 6.7%)

¹Cap-fitted forward-viewing endoscope;

²The data are per procedure, not per patient. A-loop: Afferent loop; ERCP: Endoscopic retrograde cholangiopancreatography; N/A: Not available; RUQ: Right upper quadrant; EST: Endoscopic sphincterotomy; NK: Needle knife; EPBD: Endoscopic papillary balloon dilation; EPLBD: Endoscopic papillary large balloon dilation; CBD: Common bile duct; IHD: Intrahepatic duct; F: Forward-viewing endoscope; S: Side-viewing endoscope; C: Colonoscope; SBE: Single-balloon enteroscope; DBE: Double-balloon enteroscope; AOE: Anterior oblique-viewing endoscope.