한국간담췌외과학회지 (Annals of Hepato-Biliary-Pancreatic Surgery)

  • 제26권4호
  • /
  • Pages.318-324
  • /
  • 2022
  • /
  • 2508-5778(pISSN)
  • /
  • 2508-5859(eISSN)
한국간담췌외과학회 (The Korean Association of Hepato-Biliary-Pancreatic Surgery)
권호 표지
DOI QR코드

DOI QR Code

Initial United Kingdom experience of endoscopic ultrasound-directed transgastric endoscopic retrograde cholangiopancreatography

  • Puneet Chhabra (Department of Gastroenterology, Calderdale and Huddersfield Foundation Trust) ;
  • Wei On (Department of Gastroenterology, Leeds Teaching Hospitals NHS Trust) ;
  • Bharat Paranandi (Department of Gastroenterology, Leeds Teaching Hospitals NHS Trust) ;
  • Matthew T. Huggett (Department of Gastroenterology, Leeds Teaching Hospitals NHS Trust) ;
  • Naomi Robson (Biomedical Communications, University of Toronto) ;
  • Mark Wright (Department of Interventional Endoscopy, University Hospital Southampton NHS Foundation Trust) ;
  • Ben Maher (Department of Interventional Endoscopy, University Hospital Southampton NHS Foundation Trust) ;
  • Nadeem Tehami (Department of Interventional Endoscopy, University Hospital Southampton NHS Foundation Trust)
  • 투고 : 2022.03.28
  • 심사 : 2022.04.29
  • 발행 : 2022.11.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Backgrounds/Aims: Gallstone disease is a recognized complication of bariatric surgery. Subsequent management of choledocholithiasis may be challenging due to altered anatomy which may include Roux-en-Y gastric bypass (RYGB). We conducted a retrospective service evaluation study to assess the safety and efficacy of endoscopic ultrasound-directed transgastric endoscopic retrograde cholangiopancreatography (EDGE) in patients with RYGB anatomy. Methods: All the patients who underwent EDGE for endoscopic retrograde cholangiopancreatography after RYGB at two tertiary care centers in the United Kingdom between January 2020 and October 2021 were included in the study. Clinical and demographic details were recorded for all patients. The primary outcome measures were technical and clinical success. Adverse events were recorded. Hot Axios lumen apposing metal stents measuring 20 mm in diameter and 10 mm in length were used in all the patients for creation of a gastro-gastric or gastro-jejunal fistula. Results: A total of 14 patients underwent EDGE during the study period. The majority of the patients were female (85.7%) and the mean age of patients was 65.8 ± 9.8 years. Technical success was achieved in all but one patient at the first attempt (92.8%) and clinical success was achieved in 100% of the patients. Complications arose in 3 patients with 1 patient experiencing persistent fistula and weight gain. Conclusions: In patients with RYGB anatomy, EDGE facilitated biliary access has a high rate of clinical success with an acceptable safety profile. Adverse events are uncommon and can be managed endoscopically.

키워드

참고문헌

  1. NHS Digital. Statistics on obesity, physical activity and diet: England, 2020. Leeds: NHS Digital, 2020. 
  2. Chang SH, Stoll CR, Song J, Varela JE, Eagon CJ, Colditz GA. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003-2012. JAMA Surg 2014;149:275-287. 
  3. Shenoy SS, Gilliam A, Mehanna A, Kanakala V, Bussa G, Gill T, et al. Laparoscopic sleeve gastrectomy versus laparoscopic Roux-en-Y gastric bypass in elderly bariatric patients: safety and efficacy-a systematic review and meta-analysis. Obes Surg 2020;30:4467-4473. 
  4. Stender S, Nordestgaard BG, Tybjaerg-Hansen A. Elevated body mass index as a causal risk factor for symptomatic gallstone disease: a Mendelian randomization study. Hepatology 2013;58:2133-2141. 
  5. Shiffman ML, Sugerman HJ, Kellum JM, Brewer WH, Moore EW. Gallstone formation after rapid weight loss: a prospective study in patients undergoing gastric bypass surgery for treatment of morbid obesity. Am J Gastroenterol 1991;86:1000-1005. 
  6. Li VK, Pulido N, Fajnwaks P, Szomstein S, Rosenthal R, Martinez-Duartez P. Predictors of gallstone formation after bariatric surgery: a multivariate analysis of risk factors comparing gastric bypass, gastric banding, and sleeve gastrectomy. Surg Endosc 2009;23:1640-1644. Erratum in: Surg Endosc 2009;23:1645. 
  7. Ayoub F, Brar TS, Banerjee D, Abbas AM, Wang Y, Yang D, et al. Laparoscopy-assisted versus enteroscopy-assisted endoscopic retrograde cholangiopancreatography (ERCP) in Roux-en-Y gastric bypass: a meta-analysis. Endosc Int Open 2020;8:E423-E436. 
  8. Fuente I, Beskow A, Wright F, Uad P, de Santibanes M, Palavecino M, et al. Laparoscopic transcystic common bile duct exploration as treatment for choledocholithiasis after Roux-en-Y gastric bypass. Surg Endosc. 2021;35:6913-6920. 
  9. Kedia P, Tarnasky PR, Nieto J, Steele SL, Siddiqui A, Xu MM, et al. EUS-directed transgastric ERCP (EDGE) versus laparoscopy-assisted ERCP (LA-ERCP) for Roux-en-Y gastric bypass (RYGB) anatomy: a multicenter early comparative experience of clinical outcomes. J Clin Gastroenterol 2019;53:304-308. 
  10. Skinner M, Popa D, Neumann H, Wilcox CM, Monkemuller K. ERCP with the overtube-assisted enteroscopy technique: a systematic review. Endoscopy 2014;46:560-572. 
  11. Schreiner MA, Chang L, Gluck M, Irani S, Gan SI, Brandabur JJ, et al. Laparoscopy-assisted versus balloon enteroscopy-assisted ERCP in bariatric post-Roux-en-Y gastric bypass patients. Gastrointest Endosc 2012;75:748-756. 
  12. Banerjee N, Parepally M, Byrne TK, Pullatt RC, Cote GA, Elmunzer BJ. Systematic review of transgastric ERCP in Roux-en-Y gastric bypass patients. Surg Obes Relat Dis 2017;13:1236-1242. 
  13. Abbas AM, Strong AT, Diehl DL, Brauer BC, Lee IH, Burbridge R, et al. Multicenter evaluation of the clinical utility of laparoscopy-assisted ERCP in patients with Roux-en-Y gastric bypass. Gastrointest Endosc 2018;87:1031-1039. 
  14. Grimes KL, Maciel VH, Mata W, Arevalo G, Singh K, Arregui ME. Complications of laparoscopic transgastric ERCP in patients with Roux-en-Y gastric bypass. Surg Endosc 2015;29:1753-1759. 
  15. May D, Vogels E, Parker D, Petrick A, Diehl D, Gabrielsen J. Overall outcomes of laparoscopic-assisted ERCP after Roux-en-Y gastric bypass and sphincter of Oddi dysfunction subgroup analysis. Endosc Int Open 2019;7:E1276-E1280. 
  16. Yang D, Draganov PV. ERCP in patients with Roux-en-Y gastric bypass: one size does not fit all. Gastrointest Endosc 2019;89:646. 
  17. James HJ, James TW, Wheeler SB, Spencer JC, Baron TH. Cost-effectiveness of endoscopic ultrasound-directed transgastric ERCP compared with device-assisted and laparoscopic-assisted ERCP in patients with Roux-en-Y anatomy. Endoscopy 2019;51:1051-1058. 
  18. Dhindsa BS, Dhaliwal A, Mohan BP, Mashiana HS, Girotra M, Singh S, et al. EDGE in Roux-en-Y gastric bypass: how does it compare to laparoscopy-assisted and balloon enteroscopy ERCP: a systematic review and meta-analysis. Endosc Int Open 2020;8:E163-E171. 
  19. Tucker O, Soriano I, Szomstein S, Rosenthal R. Management of choledocholithiasis after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis 2008;4:674-678. 
  20. Barclay RL, Jain A, Ferland ASB, Chen YI, Donnellan F. Living on the EDGE: Canadian experience with EUS-directed transgastric ERCP (EDGE) in patients with roux-en-Y gastric bypass anatomy. J Can Assoc Gastroenterol 2022;5:116-120. 
  21. Runge TM, Chiang AL, Kowalski TE, James TW, Baron TH, Nieto J, et al. Endoscopic ultrasound-directed transgastric ERCP (EDGE): a retrospective multicenter study. Endoscopy 2021;53:611-618. 
  22. Tyberg A, Kedia P, Tawadros A, Tarnasky PR, Gaidhane M, Nieto J, et al. EUS-directed transgastric endoscopic retrograde cholangiopancreatography (EDGE): the first learning curve. J Clin Gastroenterol 2020;54:569-572.