PMID- 37767310
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230929
IS  - 2341-4545 (Print)
IS  - 2387-1954 (Electronic)
IS  - 2387-1954 (Linking)
VI  - 30
IP  - 4
DP  - 2023 Aug
TI  - Side-Viewing Duodenoscope versus Forward-Viewing Gastroscope for Endoscopic 
      Retrograde Cholangiopancreatography in Billroth II Gastrectomy Patients.
PG  - 267-274
LID - 10.1159/000524262 [doi]
AB  - INTRODUCTION: Endoscopic retrograde cholangiopancreatography (ERCP) in patients 
      with Billroth II gastrectomy is still a challenging procedure. The optimal 
      approach, namely the type of endoscope and sphincter management, has yet to be 
      defined. AIM: To compare the efficacy and safety of forward-viewing gastroscope 
      and the side-viewing duodenoscope in ERCP of patients with Billroth II 
      gastrectomy. METHODS: We conducted a retrospective, single-center cohort study of 
      consecutive patients with Billroth II gastrectomy submitted to ERCP in an expert 
      center for ERCP between 2005 and 2021. The outcomes assessed were: papilla 
      identification, deep biliary cannulation, and adverse events (AEs). Multivariate 
      analysis was performed to evaluate potential associations and predictors of the 
      main outcomes. RESULTS: We included 83 patients with a median age of 73 (IQR 
      65-81) years. ERCP was performed using side-viewing duodenoscope in 52 and 
      forward-viewing gastroscope in 31 patients. Patients' characteristics were 
      similar in the two groups. The global rate of papilla identification was 66% (n = 
      55). The rate of deep cannulation was 58% considering all patients and 87% in the 
      subgroup of patients in which the papilla major was identified. Cannulation was 
      performed with standard methods in 65% of cases and with needle-knife fistulotomy 
      in 35%. AEs occurred in 4 patients. There was no difference between duodenoscope 
      and gastroscope in papilla identification (64% [95% CI: 51-77] vs. 71% [55-87]). 
      Although not statistically significant, duodenoscope had a lower deep cannulation 
      rate when considering all patients (52% [15-39] vs. 68% [7-35]) and a higher AEs 
      rate (8% [1-15] vs. 0% [0-1]). In a multivariate analysis, the use of gastroscope 
      significantly increased the deep cannulation rate (OR = 152.62 [2.5-9,283.6]). 
      CONCLUSION: This study demonstrates that forward-viewing gastroscope is at least 
      as effective and safe as side-viewing duodenoscope for ERCP in patients with 
      Billroth II gastrectomy. Moreover, our study showed that gastroscope is an 
      independent predictor of successful cannulation.
CI  - Copyright (c) 2022 by Sociedade Portuguesa de Gastrenterologia. Published by S. 
      Karger AG, Basel.
FAU - Marques de Sa, Ines
AU  - Marques de Sa I
AD  - Department of Gastroenterology, Portuguese Oncology Institute of Porto, Porto, 
      Portugal.
FAU - Chaves, Carlos Borges
AU  - Chaves CB
AD  - Department of Gastroenterology, Hospital Santa Luzia, Viana do Castelo, Portugal.
FAU - Correia de Sousa, Joao
AU  - Correia de Sousa J
AD  - Department of Gastroenterology, Hospital das Forcas Armadas, Porto, Portugal.
FAU - Fernandes, Joao
AU  - Fernandes J
AD  - Department of Gastroenterology, Hospital Santa Luzia, Viana do Castelo, Portugal.
FAU - Araujo, Tarcisio
AU  - Araujo T
AD  - Department of Gastroenterology, Hospital Santa Luzia, Viana do Castelo, Portugal.
FAU - Canena, Jorge
AU  - Canena J
AD  - Department of Gastroenterology, Professor Doutor Fernando Fonseca Hospital, 
      Amadora, Portugal.
AD  - Department of Gastroenterology, Nova Medical School-Faculty of Medical Sciences, 
      Lisbon, Portugal.
FAU - Lopes, Luis
AU  - Lopes L
AD  - Department of Gastroenterology, Hospital Santa Luzia, Viana do Castelo, Portugal.
AD  - Life and Health Sciences Research Institute (ICVS), School of Medicine, 
      University of Minho, Braga, Portugal.
AD  - ICVS/3B's - PT Government Associate Laboratory, Braga/Guimaraes, Portugal.
LA  - eng
PT  - Journal Article
DEP - 20220510
PL  - Switzerland
TA  - GE Port J Gastroenterol
JT  - GE Portuguese journal of gastroenterology
JID - 101685861
PMC - PMC10521316
OTO - NOTNLM
OT  - Billroth II operation
OT  - Duodenoscope
OT  - Endoscopic retrograde cholangiopancreatography
OT  - Gastroscope
COIS- The authors declare no conflicts of interest.
EDAT- 2022/05/10 00:00
MHDA- 2022/05/10 00:01
PMCR- 2022/05/10
CRDT- 2023/09/28 04:14
PHST- 2021/09/27 00:00 [received]
PHST- 2022/01/17 00:00 [accepted]
PHST- 2022/05/10 00:01 [medline]
PHST- 2022/05/10 00:00 [pubmed]
PHST- 2023/09/28 04:14 [entrez]
PHST- 2022/05/10 00:00 [pmc-release]
AID - pjg-0030-0267 [pii]
AID - 10.1159/000524262 [doi]
PST - epublish
SO  - GE Port J Gastroenterol. 2022 May 10;30(4):267-274. doi: 10.1159/000524262. 
      eCollection 2023 Aug.