Erschienen in:
04.10.2018 | Review Article
Comparison between Enteroscopy-Based and Laparoscopy-Assisted ERCP for Accessing the Biliary Tree in Patients with Roux-en-Y Gastric Bypass: Systematic Review and Meta-analysis
verfasst von:
Alberto Machado da Ponte-Neto, Wanderley M. Bernardo, Lara M. de A. Coutinho, Iatagan Rocha Josino, Vitor Ottoboni Brunaldi, Diogo T. H. Moura, Paulo Sakai, Rogério Kuga, Eduardo G. H. de Moura
Erschienen in:
Obesity Surgery
|
Ausgabe 12/2018
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Abstract
Although balloon-assisted enteroscopy-endoscopic retrograde cholangiopancreatography (BAE-ERCP) is a well-described means of accessing the duodenal papilla in patients with Roux-en-Y gastric bypass (RYGB), it is associated with modest clinical success rates. Laparoscopy-assisted ERCP (LA-ERCP)—performed by advancing a standard duodenoscope through a gastrostomy into the excluded stomach and duodenum—has emerged as a viable alternative to BAE-ERCP, with apparently higher success rates. In this systematic review, we compare LA-ERCP with enteroscopy-based techniques in post-RYGB patients, including 22 case series that provided data on papilla identification, papilla cannulation, and complications. We found that LA-ERCP was superior to the enteroscopy-based techniques in its capacity to reach the duodenal papilla, although complication rates were lower for the latter. Comparative studies are needed in order to corroborate our findings.