Skip to main content
main-content
Erschienen in: Surgical Endoscopy 1/2021

16.01.2020 | gastrectomy

Outcomes of endoscopic treatment for malignant biliary obstruction in patients with surgically altered anatomy: analysis of risk factors for clinical failure

verfasst von: Takeshi Tomoda, Hironari Kato, Kazuya Miyamoto, Akihiro Matsumi, Eijiro Ueta, Yuuki Fujii, Yousuke Saragai, Tatsuhiro Yamazaki, Daisuke Uchida, Kazuyuki Matsumoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada

Erschienen in: Surgical Endoscopy | Ausgabe 1/2021

Einloggen, um Zugang zu erhalten

Abstract

Background

To evaluate the outcomes of endoscopic retrograde cholangiopancreatography (ERCP) for malignant biliary obstruction (MBO) using short-type double-balloon enteroscope (sDBE) in patients with surgically altered anatomy.

Methods

A total of 45 patients with surgically altered anatomy underwent ERCP using sDBE for the treatment of MBO between April 2011 and March 2019. We retrospectively evaluated the clinical and technical success (insertion and biliary intervention success), adverse events, and risk factors for clinical failure.

Results

The scope was successfully inserted in the target site in 82.2% of patients (37/45), and among them, biliary intervention success was achieved in 86.4% (32/37). The overall technical success rate was 71.1% (32/45) and clinical success rate was 68.9% (31/45), with an adverse event rate of 11.1%. In multivariate analysis, the presence of peritoneal dissemination (odds ratio, 7.3; 95% confidence interval, 1.5–43.5, p = 0.02) was as an independent risk factor for clinical failure. The clinical success rate was 38.5% in patients with peritoneal dissemination and 81.3% in those without peritoneal dissemination.

Conclusion

Endoscopic treatment using sDBE in patients without peritoneal dissemination provided favorable outcomes, and it can be an initial treatment for MBO in patients with surgically altered anatomy.
Literatur
1.
Zurück zum Zitat Speer AG, Cotton PB, Russell RC et al (1987) Randomised trial of endoscopic versus percutaneous stent insertion in malignant obstructive jaundice. Lancet 2:57–62 CrossRef Speer AG, Cotton PB, Russell RC et al (1987) Randomised trial of endoscopic versus percutaneous stent insertion in malignant obstructive jaundice. Lancet 2:57–62 CrossRef
2.
Zurück zum Zitat Andersen JR, Sorensen SM, Kruse A, Rokkjaer M, Matzen P (1989) Randomised trial of endoscopic endoprosthesis versus operative bypass in malignant obstructive jaundice. Gut 30:1132–1135 CrossRef Andersen JR, Sorensen SM, Kruse A, Rokkjaer M, Matzen P (1989) Randomised trial of endoscopic endoprosthesis versus operative bypass in malignant obstructive jaundice. Gut 30:1132–1135 CrossRef
3.
Zurück zum Zitat Smith AC, Dowsett JF, Russell RC, Hatfield AR, Cotton PB (1994) Randomised trial of endoscopic stenting versus surgical bypass in malignant low bileduct obstruction. Lancet 344:1655–1660 CrossRef Smith AC, Dowsett JF, Russell RC, Hatfield AR, Cotton PB (1994) Randomised trial of endoscopic stenting versus surgical bypass in malignant low bileduct obstruction. Lancet 344:1655–1660 CrossRef
4.
Zurück zum Zitat Liu K, Joshi V, Saxena P, Kaffes AJ (2017) Predictors of success for double balloon-assisted endoscopic retrograde cholangiopancreatography in patients with Roux-en-Y anastomosis. Dig. Endosc. 29:190–197 CrossRef Liu K, Joshi V, Saxena P, Kaffes AJ (2017) Predictors of success for double balloon-assisted endoscopic retrograde cholangiopancreatography in patients with Roux-en-Y anastomosis. Dig. Endosc. 29:190–197 CrossRef
5.
Zurück zum Zitat Shimatani M, Hatanaka H, Kogure H et al (2016) Diagnostic and therapeutic endoscopic retrograde cholangiography using a short-type double-balloon endoscope in patients with altered gastrointestinal anatomy: a multicenter prospective study in Japan. Am. J. Gastroenterol. 111:1750–1758 CrossRef Shimatani M, Hatanaka H, Kogure H et al (2016) Diagnostic and therapeutic endoscopic retrograde cholangiography using a short-type double-balloon endoscope in patients with altered gastrointestinal anatomy: a multicenter prospective study in Japan. Am. J. Gastroenterol. 111:1750–1758 CrossRef
7.
Zurück zum Zitat Lenze F, Meister T, Matern P et al (2014) Single-balloon enteroscopy assisted endoscopic retrogradecholangiopancreaticography in patients with surgically altered anatomy: higherfailure rate in malignant biliary obstruction -a prospective single center cohort analysis. Scand J Gastroenterol. 49:766–771 CrossRef Lenze F, Meister T, Matern P et al (2014) Single-balloon enteroscopy assisted endoscopic retrogradecholangiopancreaticography in patients with surgically altered anatomy: higherfailure rate in malignant biliary obstruction -a prospective single center cohort analysis. Scand J Gastroenterol. 49:766–771 CrossRef
9.
Zurück zum Zitat Cotton PB, Eisen GM, Aabakken L et al (2010) A lexicon for endoscopic adverse events: report of an ASGE workshop. Gastrointest Endosc 71:446–454 CrossRef Cotton PB, Eisen GM, Aabakken L et al (2010) A lexicon for endoscopic adverse events: report of an ASGE workshop. Gastrointest Endosc 71:446–454 CrossRef
10.
Zurück zum Zitat Hara K, Yamao K, Niwa Y et al (2011) Prospective clinical study of EUS-guided choledochoduodenostomy for malignant lower biliary tract obstruction. Am. J. Gastroenterol. 106:1239–1245 CrossRef Hara K, Yamao K, Niwa Y et al (2011) Prospective clinical study of EUS-guided choledochoduodenostomy for malignant lower biliary tract obstruction. Am. J. Gastroenterol. 106:1239–1245 CrossRef
11.
Zurück zum Zitat Khan MA, Akbar A, Baron TH et al (2016) Endoscopic ultrasoundguided biliary drainage: a systematic review and meta-analysis. Dig. Dis. Sci. 61:684–703 CrossRef Khan MA, Akbar A, Baron TH et al (2016) Endoscopic ultrasoundguided biliary drainage: a systematic review and meta-analysis. Dig. Dis. Sci. 61:684–703 CrossRef
12.
Zurück zum Zitat Wang K, Zhu J, Xing L, Wang Y, Jin Z, Li Z (2016) Assessment of efficacy and safety of EUS-guided biliary drainage: a systematic review. Gastrointest. Endosc. 83:1218–1227 CrossRef Wang K, Zhu J, Xing L, Wang Y, Jin Z, Li Z (2016) Assessment of efficacy and safety of EUS-guided biliary drainage: a systematic review. Gastrointest. Endosc. 83:1218–1227 CrossRef
13.
Zurück zum Zitat Moole H, Bechtold ML, Forcione D, Puli SR (2017) A metaanalysis and systematic review: success of endoscopic ultrasound guided biliary stenting in patients with inoperable malignant biliary strictures and a failed ERCP. Medicine 96:e5154 CrossRef Moole H, Bechtold ML, Forcione D, Puli SR (2017) A metaanalysis and systematic review: success of endoscopic ultrasound guided biliary stenting in patients with inoperable malignant biliary strictures and a failed ERCP. Medicine 96:e5154 CrossRef
14.
Zurück zum Zitat Minaga K, Kitano M (2018) Recent advances in endoscopic ultrasound-guided biliary drainage. Dig. Endosc. 30:38–47 CrossRef Minaga K, Kitano M (2018) Recent advances in endoscopic ultrasound-guided biliary drainage. Dig. Endosc. 30:38–47 CrossRef
Metadaten
Titel
Outcomes of endoscopic treatment for malignant biliary obstruction in patients with surgically altered anatomy: analysis of risk factors for clinical failure
verfasst von
Takeshi Tomoda
Hironari Kato
Kazuya Miyamoto
Akihiro Matsumi
Eijiro Ueta
Yuuki Fujii
Yousuke Saragai
Tatsuhiro Yamazaki
Daisuke Uchida
Kazuyuki Matsumoto
Shigeru Horiguchi
Koichiro Tsutsumi
Hiroyuki Okada
Publikationsdatum
16.01.2020
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 1/2021
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-020-07385-y

Weitere Artikel der Ausgabe 1/2021

Surgical Endoscopy 1/2021 Zur Ausgabe

Neu im Fachgebiet Chirurgie

Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Chirurgie und bleiben Sie gut informiert – ganz bequem per eMail.