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Obata, Taisuke Department of Gastroenterology, Okayama University Hospital
Tsutsumi, Koichiro Department of Gastroenterology, Okayama University Hospital ORCID Kaken ID researchmap
Kato, Hironari Department of Gastroenterology, Okayama University Hospital ORCID Kaken ID researchmap
Ueki, Toru Department of Internal Medicine, Fukuyama City Hospital
Miyamoto, Kazuya Department of Internal Medicine, Tsuyama Chuo Hospital
Yamazaki, Tatsuhiro Department of Gastroenterology, Okayama University Hospital
Matsumi, Akihiro Department of Gastroenterology, Okayama University Hospital
Fujii, Yuki Department of Gastroenterology, Okayama University Hospital
Matsumoto, Kazuyuki Department of Gastroenterology, Okayama University Hospital ORCID Kaken ID publons
Horiguchi, Shigeru Department of Gastroenterology, Okayama University Hospital
Yasugi, Kengo Department of Internal Medicine, Fukuyama City Hospital
Ogawa, Tsuneyoshi Department of Internal Medicine, Fukuyama City Hospital
Takenaka, Ryuta Department of Internal Medicine, Tsuyama Chuo Hospital
Okada, Hiroyuki Department of Gastroenterology, Okayama University Hospital Kaken ID publons researchmap
Abstract
Background: Endoscopic retrograde cholangiopancreatography (ERCP) for extraction of common bile duct (CBD) stones in patients with Roux-en-Y gastrectomy (RYG) remains technically challenging. Methods: Seventy-nine RYG patients (median 79 years old) underwent short-type double-balloon enteroscopy-assisted ERCP (sDBE-ERCP) for CBD stones at three referral hospitals from 2011-2020. We retrospectively investigated the treatment outcomes and potential factors affecting complete stone extraction.

Results: The initial success rates of reaching the papilla of Vater, biliary cannulation, and biliary intervention, including complete stone extraction or biliary stent placement, were 92%, 81%, and 78%, respectively. Of 57 patients with attempted stone extraction, complete stone extraction was successful in 74% for the first session and ultimately in 88%. The adverse events rate was 5%. The multivariate analysis indicated that the largest CBD diameter >= 14 mm (odds ratio (OR), 0.04; 95% confidence interval (CI), 0.01-0.58; p = 0.018) and retroflex position (OR, 6.43; 95% CI, 1.12-36.81; p = 0.037) were independent predictive factors affecting complete stone extraction achievement.

Conclusions: Therapeutic sDBE-ERCP for CBD stones in a relatively elderly RYG cohort, was effective and safe. A larger CBD diameter negatively affected complete stone extraction, but using the retroflex position may be useful for achieving complete stone clearance.
Keywords
bile duct stone
endoscopic retrograde cholangiography
Roux-en-Y anastomosis
short-type balloon enteroscopy
complete stone removal
gastrectomy
Published Date
2021-07-27
Publication Title
Journal of Clinical Medicine
Volume
volume10
Issue
issue15
Publisher
MDPI
Start Page
3314
ISSN
2077-0383
Content Type
Journal Article
language
英語
OAI-PMH Set
岡山大学
Copyright Holders
© 2021 by the authors.
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isVersionOf https://doi.org/10.3390/jcm10153314
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https://creativecommons.org/licenses/by/4.0/