Copyright
©The Author(s) 2019.
World J Gastroenterol. Jun 28, 2019; 25(24): 3091-3107
Published online Jun 28, 2019. doi: 10.3748/wjg.v25.i24.3091
Published online Jun 28, 2019. doi: 10.3748/wjg.v25.i24.3091
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%) |
Table 2 Detailed characteristics of the most recently published studies with more than 100 patients
Bove et al[17], 2015 | Wu et al[18], 2016 | Park et al[19], 2016 | |
(n = 713) | (n = 135) | (n = 165) | |
Study design | Retrospective cohort in single center | Retrospective cohort in single center | Retrospective cohort in 5 centers |
Male gender, n (%) | 567 (79.5) | N/A | 116 (70.3) |
Age (yr), n (%) or mean ± SD | > 60 yr, 565 (79.2) | N/A | 71.1 ± 10.0 |
Type of endoscope | Side-viewing or forward-viewing | Side-viewing | Cap-fitting forward- viewing |
Type of sphincter therapy | EST | EST | EPBD±NK |
Success of afferent loop intubation, n (%) | 618/713 (86.7) | 120/135 (88.8) | 151/165 (91.5) |
Success of selective cannulation, n (%) | 580/618 (93.8) | 117/120 (97.5) | 144/151 (95.4) |
Bowel perforation, n (%) | 22/713 (3.1) | 1/135 (0.7) | 3/165 (1.8) |
Post-ERCP pancreatitis, n (%) | 5/713 (0.7) | N/A | 13/165 (7.9) |
Bleeding, n (%) | 11/713 (1.5) | N/A | - |
Mortality, n (%) | 2/713 (0.3) | - | - |
Table 3 Results of the systematic review
No. (%) | |
Study design, n (%) | |
Retrospective cohort | 36/43 (83.7) |
Retrospective comparative | 4/43 (9.3) |
Prospective comparative | 2/43 (4.7) |
Prospective cohort | 1/43 (2.3) |
Total number of identified patients | 2669 |
1Type of endoscope, n (%) | |
Side-viewing endoscope | 1432/2575 (55.6) |
Forward-viewing endoscope | 664/2575 (25.8) |
Balloon-assisted enteroscope | 197/2575 (7.7) |
Anterior oblique-viewing endoscope | 169/2575 (6.6) |
Dual-lumen endoscope | 64/2575 (2.5) |
Colonoscope | 31/2575 (1.2) |
Multiple bending endoscope | 14/2575 (0.5) |
Others | 4/2575 (0.2) |
Overall success of afferent loop intubation, n (%) | 2437/2669 (91.3) |
Overall success of selective cannulation, n (%) | 2346/2437 (87.9) |
Overall adverse events, n (%) | 195 (7.3) |
Bowel perforation | 74 (2.8) |
Post-ERCP pancreatitis | 65 (2.4) |
Bleeding | 37 (1.4) |
Mortality | 9 (0.3) |
2Others | 10 (0.4) |
Table 4 Subgroup analysis according to the type of endoscope
Side-viewing endoscope | Forward-viewing endoscope | Balloon-assisted enteroscope | Oblique-viewing endoscope | Dual-lumen endoscope | |
(n = 1432) | (n = 664) | (n = 197) | (n = 169) | (n = 64) | |
Afferent loop intubation, n (%) | 1406 (98.2) | 647 (97.4) | 188 (95.4) | 159 (94.1) | 53(82.8) |
Selective cannulation, n (%) | 1340 (95.3) | 616 (95.2) | 179 (97.5) | 155 (97.5) | 53 (100) |
Adverse events, n (%) | 113 (7.9) | 47 (7.1) | 14 (7.1) | 6 (3.6) | 3 (4.7) |
Bowel perforation, n (%) | 51 (3.6) | 11 (1.7) | 8 (4.1) | 2 (1.2) | 2 (3.1) |
Post-ERCP pancreatitis, n (%) | 26 (1.8) | 27 (4.1) | 6 (3.0) | 3 (1.8) | 1 (1.6) |
Bleeding, n (%) | 27(1.9) | 9 (1.4) | - | 1 (0.6) | - |
Mortality, n (%) | 9 (0.6) | - | - | - | - |
Table 5 Subgroup analysis according to the sphincter management methods
EST | EST+EPBD | EPBD | EPLBD | |
(n = 1478) | (n = 598) | (n = 246) | (n = 171) | |
1Clinical success, n (%) | 1268 (85.8) | 546 (91.3) | 214 (87.0) | 160 (93.6) |
Adverse events, n (%) | 103 (7.0) | 38 (6.4) | 21 (8.5) | 10 (5.8) |
Bowel perforation, n (%) | 51 (3.5) | 8 (1.3) | 5 (2.0) | 3 (1.8) |
Post-ERCP pancreatitis, n (%) | 18 (1.2) | 22 (3.7) | 16 (6.5) | 4 (2.3) |
Bleeding, n (%) | 25 (1.7) | 8 (1.3) | - | 3 (1.8) |
Mortality, n (%) | 9 (0.6) | - | - |
- Citation: Park TY, Song TJ. Recent advances in endoscopic retrograde cholangiopancreatography in Billroth II gastrectomy patients: A systematic review. World J Gastroenterol 2019; 25(24): 3091-3107
- URL: https://www.wjgnet.com/1007-9327/full/v25/i24/3091.htm
- DOI: https://dx.doi.org/10.3748/wjg.v25.i24.3091