Application of single balloon enteroscopy-assisted therapeutic endoscopic retrograde cholangiopancreatography in patients after bilioenteric Roux-en-Y anastomosis: Experience of multi-disciplinary collaboration

Table 1 Baseline characteristics of study patients (n = 46)

Characteristic	Value
Age, yr, mean ± SD	72.1 ± 11.2
Male gender, n (%)	27 (58.7)
Indication for ERCP, n (%)
Common bile duct stone	32 (69.6)
Benign biliary stricture	20 (43.5)
Pancreaticobiliary malignancy	6 (13.0)
Foreign body at the anastomotic site	10 (21.7)
Duration since bilioenteric Roux-en-Y anastomosis, n (%)
≤ 5 yr
> 5 yr
Prior operation history
Pancreatico-duodenectomy	18 (39.1%)
Bilioenteric Roux-en-Y anastomosis	25 (54.3%)
Total pancreatectomy	1 (2.2%)
Billroth II gastroenterostomy + pancreatico-duodenectomy	1 (2.2%)
Bilioenteric Roux-en-Y anastomosis + pancreatico-duodenectomy	1 (2.2%)

SD: Standard deviation; ERCP: Endoscopic retrograde cholangiopancreatography.

Table 2 Clinical outcomes of endoscopic retrograde cholangiopancreatography in the study cohort

Outcome	No. of patients, n (%)
Technical success
Enteroscopy success	60 (93.8)
Diagnostic success	59 (92.2)
ERCP success	59 (92.2)
Intervention
Stone extraction	31(48.4)
Holmium laser lithotripsy	8 (12.5)
Anastomotic incision	10 (15.6)
Balloon dilation of stenotic anastomosis	19 (29.7)
ENBD	30 (46.8)
Biliary plastic stent placement and removal	6 (9.4)
Foreign body extraction	10 (15.6)
Reason for ERCP failure
Failure to reach the papilla	4 (6.3)
Failure of selective bile duct cannulation	1 (1.6)
Failure of bile duct stone removal or ERBD insertion	0 (0)
Failure because of afferent loop perforation	0 (0)
Overall adverse events	0 (0)
Perforation	0 (0)
Pancreatitis	0 (0)
Bleeding	0 (0)

ERCP: Endoscopic retrograde cholangiopancreatography; ENBD: Edoscopic retrograde biliary drainage.

Table 3 Summary of reports of endoscopic retrograde cholangiopancreatography using single-balloon enteroscopy technique in patients with Roux-en-Y anastomosis

Author	Publication year	Number of procedures	Enteroscopy success rate	ERCP success rate	Complication rate
Dellon et al[18]	2009	4	75%	75%	0
Saleem et al[19]	2010	50	75%	66%	0
Shah et al[10]	2013	45	69%	60%	No data
Tomizawa et al[20]	2014	14	68%	50%	0
Soh et al[21]	2015	6	83.3%	50%	16.7%
Yane et al[22]	2016	183	91.8%	80.3%	No data

ERCP: Endoscopic retrograde cholangiopancreatography; SBE: Single-balloon enteroscopy.