Copyright
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Double-balloon endoscopic retrograde cholangiopancreatography for patients who underwent liver operation: A retrospective study
Ryo Nishio, Hiroki Kawashima, Masanao Nakamura, Eizaburo Ohno, Takuya Ishikawa, Takeshi Yamamura, Keiko Maeda, Tsunaki Sawada, Hiroyuki Tanaka, Daisuke Sakai, Ryoji Miyahara, Masatoshi Ishigami, Yoshiki Hirooka, Mitsuhiro Fujishiro
Ryo Nishio, Masanao Nakamura, Eizaburo Ohno, Takuya Ishikawa, Hiroyuki Tanaka, Daisuke Sakai, Ryoji Miyahara, Masatoshi Ishigami, Mitsuhiro Fujishiro, Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Aichi Prefecture, Nagoya 4668550, Japan
Hiroki Kawashima, Takeshi Yamamura, Keiko Maeda, Tsunaki Sawada, Department of Endoscopy, Nagoya University Hospital, Aichi Prefecture, Nagoya 4668550, Japan
Yoshiki Hirooka, Department of Liver, Biliary Tract and Pancreas Diseases, Fujita Health University Hospital, Aichi Prefecture, Toyoake 4701192, Japan
Author contributions: Nishio R contributed to the conception and design; Nishio R, Kawashima H and Ishikawa T contributed to the analysis and interpretation of the data; Nishio R drafted the article; Kawashima H, Nakamura M, Ohno E, Ishikawa T, Yamamura T, Maeda K, Sawada T, Tanaka H, Sakai D, Miyahara R, Masatoshi Ishigami M and Hirooka Y contributed to critical revision of the article for important intellectual content; Fujishiro M made final approval of the article.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Nagoya University Hospital.
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine is receiving a scholarship donation from FUJIFILM. There are no additional conflict of interest that would pertain to the content of this study.
Data sharing statement: No additional data are available.
Open-Access: This article 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 NonCommercial (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: Hiroki Kawashima, MD, PhD, Associate Professor, Department of Endoscopy, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Aichi Prefecture, Nagoya 4668550, Japan. h-kawa@med.nagoya-u.ac.jp
Received: November 26, 2019
Peer-review started: November 26, 2019
First decision: January 7, 2020
Revised: January 14, 2020
Accepted: February 15, 2020
Article in press: February 15, 2020
Published online: March 14, 2020
ARTICLE HIGHLIGHTS
Research background
Double-balloon endoscopic retrograde cholangiography (DB-ERC) is widely performed for biliary diseases after reconstruction in gastrointestinal surgery, but the success rates and the examination time varied by reconstruction methods.
Research motivation
There are few reports on DB-ERC after hepatectomy or living donor liver transplantation (LDLT), and we have experienced many cases requiring DB-ERC after hepatectomy or LDLT performed in our hospital.
Research objectives
The objective of this study is to examine the success rates and safety of DB-ERC after hepatectomy or LDLT, and to reveal the inherent difficulties of them.
Research methods
The study was performed retrospectively in patients who underwent DB-ERC after hepatectomy or LDLT [hereinafter referred to as liver operation (LO) group] and control patients after pancreatoduodenectomy (control group). The technical success (endoscope reaching the choledochojejunostomy site), diagnostic success (performance of cholangiography), therapeutic success (completed interventions) and overall success rates, insertion and procedure (completion of DB-ERC) time, and adverse events were compared between these groups.
Research results
There were no significant differences between the LO and control groups for the success rates and the incidence of adverse events, but the median insertion time and procedure time were significantly longer in the LO group.
Research conclusions
DB-ERC is safe and useful for patients who underwent hepatectomy or LDLT. Although it may be difficult because of not only gastrointestinal reconstruction, but also lower liver volume: changes in running of gastrointestinal tract due to successive hepatomegaly: and easy bending upon insertion of the endoscope. So particular care with the endoscope and obtaining informed consent are essential before DB-ERC is performed.
Research perspectives
DB-ERC will be performed safely and easily for patients who underwent any gastrointestinal reconstruction.
