Retrospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 28, 2019; 25(36): 5505-5514
Published online Sep 28, 2019. doi: 10.3748/wjg.v25.i36.5505
Application of single balloon enteroscopy-assisted therapeutic endoscopic retrograde cholangiopancreatography in patients after bilioenteric Roux-en-Y anastomosis: Experience of multi-disciplinary collaboration
Wen-Guang Wu, Lu-Cui Qin, Xiao-Ling Song, Ming-Ning Zhao, Wen-Jie Zhang, Jun Gu, Hao Weng, Ying-Bin Liu, Yi Zhang, Chun-Ying Qu, Lei-Ming Xu, Xue-Feng Wang
Wen-Guang Wu, Xiao-Ling Song, Ming-Ning Zhao, Wen-Jie Zhang, Jun Gu, Hao Weng, Ying-Bin Liu, Xue-Feng Wang, Department of General Surgery and Laboratory of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
Lu-Cui Qin, Department of Operating Room, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
Xiao-Ling Song, Ying-Bin Liu, Shanghai Key Laboratory of Biliary Tract Disease Research, Shanghai 200092, China
Yi Zhang, Chun-Ying Qu, Lei-Ming Xu, Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
Author contributions: Wu WG, Qin LC, and Song XL contributed equally to this work; Wu WG, Qin LC, Zhao MN, and Wang XF contributed to the study concept and design; Qin LC, Song XL, Zhang WJ, Gu J, and Weng H contributed to data acquisition; Song XL, Zhang WJ, Gu J, and Weng H contributed to analysis and interpretation of the data; Wu WG, Zhao MN, Song XL, and Wang XF contributed to drafting of the manuscript; Wu WG, Qin LC, Zhao MN, Song XL, and Wang XF contributed to critical revision of the manuscript for important intellectual content; Gu J and Weng H analyzed the data; Liu YB, Zhang Y, Qu CY, and Xu LM contributed to administrative, technical, or material support; Wang XF supervised the study.
Supported by the National Natural Science Foundation of China, No. 31600075.
Institutional review board statement: This study was approved by the Ethics Committee of the Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare no conflict of interest. The authors declare that they have nothing to disclose.
Data sharing statement: No additional data are available.
Open-Access: This is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xue-Feng Wang, MD, Chief Doctor, Department of General Surgery and Laboratory of General Surgery, Xinhua Hospital Affliated to Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Road, Shanghai 200092, China. wangxuefeng@xinhuamed.com.cn
Telephone: +86-21-25077884 Fax: +86-21-25076880
Received: June 24, 2019
Peer-review started: June 24, 2019
First decision: July 21, 2019
Revised: August 14, 2019
Accepted: August 24, 2019
Article in press: August 24, 2019
Published online: September 28, 2019
Processing time: 96 Days and 9.1 Hours
ARTICLE HIGHLIGHTS
Research background

Bilioenteric Roux-en-Y anastomosis is one of the most complicated approaches for reconstructing the gastrointestinal tract, and endoscopic retrograde cholangiopancreatography (ERCP) is technically challenging in patients with bilioenteric Roux-en-Y anastomosis. The optimal endoscopic strategies for such cases remain unknown.

Research motivation

The motivation of this research was to explore the feasibility and effectiveness of single balloon enteroscopy-assisted (SBE-assisted) therapeutic ERCP in patients after bilioenteric Roux-en-Y anastomosis based on multi-disciplinary collaboration between endoscopists and surgeons.

Research objectives

To explore the feasibility and effectiveness of SBE-assisted therapeutic ERCP in patients after bilioenteric Roux-en-Y anastomosis based on multi-disciplinary collaboration between endoscopists and surgeons as well as report the experience from China.

Research methods

This is a single center retrospective study. All of the SBE-assisted therapeutic ERCP procedures were performed by the collaboration between endoscopists and surgeons. The operation time, success rate, and complication rate were calculated.

Research results

Forty-six patients received a total of 64 SBE-assisted therapeutic ERCP procedures, with successful scope intubation in 60 (93.8%) cases and successful diagnosis in 59 (92.2%). All successfully diagnosed cases received successful therapy. None of the cases had perforation or bleeding during or after operation, and no post-ERCP pancreatitis occurred.

Research conclusions

Based on multi-disciplinary collaboration, SBE-assisted therapeutic ERCP in patients after bilioenteric Roux-en-Y anastomosis is relatively safe and effective and has a high success rates.

Research perspectives

Our results are encouraging for the support of SBE-assisted ERCP, and further large prospective, and multicenter studies to evaluate the efficacy of SBE-ERCP need to be conducted to confirm these findings.