PMID- 26546981
OWN - NLM
STAT- MEDLINE
DCOM- 20170802
LR  - 20170929
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 83
IP  - 6
DP  - 2016 Jun
TI  - Outcomes of ERCP in Billroth II gastrectomy patients.
PG  - 1193-201
LID - S0016-5107(15)03052-7 [pii]
LID - 10.1016/j.gie.2015.10.036 [doi]
AB  - BACKGROUND AND AIMS: ERCP is a difficult procedure to perform in Billroth II 
      gastrectomy patients because of altered anatomy. We investigated the outcomes and 
      risk factors for adverse events with ERCP using a cap-fitted forward-viewing 
      endoscope with endoscopic papillary balloon dilation (EPBD) in Billroth II 
      gastrectomy patients. METHODS: The records for Billroth II gastrectomy patients 
      who underwent ERCP using a cap-fitted forward-viewing endoscope with EPBD at 5 
      institutions between August 2008 and April 2014 were retrospectively reviewed. 
      The outcomes and risk factors for adverse events resulting from this treatment 
      were analyzed. RESULTS: In total, 165 patients were identified. ERCP was 
      technically successful in 144 patients (87.3%) and clinically successful in 141 
      patients (85.5%). Adverse events occurred in 38 patients (23.0%): perforation in 
      3 cases (1.8%), pancreatitis in 13 cases (7.9%), and asymptomatic hyperamylasemia 
      in 22 patients (13.3%). In univariate analysis, >/=2 ERCP sessions, periampullary 
      diverticulum, and common bile duct (CBD) stone size >/= 12 mm were found to be 
      associated with ERCP-related adverse events. In multivariate analysis, >/=2 ERCP 
      sessions (odds ratio [OR], 4.762; 95% confidence interval [CI], 1.472-15.402; P = 
      .009) and a CBD stone size >/= 12 mm (OR, 3.213; 95% CI, 1.140-9.057; P = .027) 
      were significant. CONCLUSIONS: ERCP using a cap-fitted forward-viewing endoscope 
      with EPBD is feasible in Billroth II gastrectomy patients. In patients with >/=2 
      ERCP sessions or a CBD stone size >/= 12 mm, special attention should be paid to 
      the possible occurrence of significant adverse events.
CI  - Copyright (c) 2016 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Park, Tae Young
AU  - Park TY
AD  - Department of Internal Medicine, Hallym University Chuncheon Sacred Heart 
      Hospital, Hallym University College of Medicine, Chuncheon, Korea.
FAU - Kang, Jong Sik
AU  - Kang JS
AD  - Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, 
      Korea.
FAU - Song, Tae Jun
AU  - Song TJ
AD  - Division of Gastroenterology, Asan Medical Center, University of Ulsan College of 
      Medicine, Seoul, Korea.
FAU - Lee, Sang Soo
AU  - Lee SS
AD  - Division of Gastroenterology, Asan Medical Center, University of Ulsan College of 
      Medicine, Seoul, Korea.
FAU - Lee, Hyuk
AU  - Lee H
AD  - Department of Health Screening and Promotion Center, Asan Medical Center, 
      University of Ulsan College of Medicine, Seoul, Korea.
FAU - Choi, Jung Sik
AU  - Choi JS
AD  - Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, 
      Korea.
FAU - Kim, Hong Jun
AU  - Kim HJ
AD  - Department of Internal Medicine, Gyeongsang National University College of 
      Medicine, Jinju, Korea.
FAU - Jang, Ji Woong
AU  - Jang JW
AD  - Department of Internal Medicine, Eulgi University College of Medicine, Daejeon, 
      Korea.
LA  - eng
PT  - Journal Article
DEP - 20151104
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
CIN - Gastrointest Endosc. 2016 Jun;83(6):1202-4. PMID: 27206586
MH  - Aged
MH  - Aged, 80 and over
MH  - Ampulla of Vater/*surgery
MH  - Bile Duct Diseases/surgery
MH  - Bile Duct Neoplasms/*surgery
MH  - Cholangiopancreatography, Endoscopic Retrograde/instrumentation/*methods
MH  - Choledocholithiasis/*surgery
MH  - Constriction, Pathologic
MH  - Dilatation
MH  - Female
MH  - *Gastrectomy
MH  - *Gastroenterostomy
MH  - Humans
MH  - Intestinal Perforation/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Odds Ratio
MH  - Pancreatic Neoplasms/*surgery
MH  - Pancreatitis/epidemiology
MH  - Postoperative Complications/epidemiology
MH  - Retrospective Studies
MH  - Risk Factors
EDAT- 2015/11/08 06:00
MHDA- 2017/08/03 06:00
CRDT- 2015/11/08 06:00
PHST- 2015/06/09 00:00 [received]
PHST- 2015/10/25 00:00 [accepted]
PHST- 2015/11/08 06:00 [entrez]
PHST- 2015/11/08 06:00 [pubmed]
PHST- 2017/08/03 06:00 [medline]
AID - S0016-5107(15)03052-7 [pii]
AID - 10.1016/j.gie.2015.10.036 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2016 Jun;83(6):1193-201. doi: 10.1016/j.gie.2015.10.036. 
      Epub 2015 Nov 4.