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Nishio R, Kawashima H, Nakamura M, Ohno E, Ishikawa T, Yamamura T, Maeda K, Sawada T, Tanaka H, Sakai D, Miyahara R, Ishigami M, Hirooka Y, Fujishiro M. Double-balloon endoscopic retrograde cholangiopancreatography for patients who underwent liver operation: A retrospective study. World J Gastroenterol 2020; 26:1056-1066. [PMID: 32205996 PMCID: PMC7081002 DOI: 10.3748/wjg.v26.i10.1056] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/14/2020] [Accepted: 02/14/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Double-balloon endoscopic retrograde cholangiography (DB-ERC) is widely performed for biliary diseases after reconstruction in gastrointestinal surgery, but there are few reports on DB-ERC after hepatectomy or living donor liver transplantation (LDLT).
AIM To examine the success rates and safety of DB-ERC after hepatectomy or LDLT.
METHODS The study was performed retrospectively in 26 patients (45 procedures) who underwent hepatectomy or LDLT (liver operation: LO group) and 40 control patients (59 procedures) who underwent pancreatoduodenectomy (control group). The technical success (endoscope reaching the choledochojejunostomy site), diagnostic success (performance of cholangiography), therapeutic success (completed interventions) and overall success rates, insertion and procedure (completion of DB-ERC) time, and adverse events were compared between these groups.
RESULTS There were no significant differences between LO and control groups in the technical [93.3% (42/45) vs 96.6% (57/59), P = 0.439], diagnostic [83.3% (35/42) vs 83.6% (46/55), P = 0.968], therapeutic [97.0% (32/33) vs 97.7% (43/44), P = 0.836], and overall [75.6% (34/45) vs 79.7% (47/59), P = 0.617] success rates. The median insertion time (22 vs 14 min, P < 0.001) and procedure time (43.5 vs 30 min, P = 0.033) were significantly longer in the LO group. The incidence of adverse events showed no significant difference [11.1% (5/45) vs 6.8% (4/59), P = 0.670].
CONCLUSION DB-ERC after liver operation is safe and useful but longer time is required, so should be performed with particular care.
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Affiliation(s)
- Ryo Nishio
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Aichi Prefecture, Nagoya 4668550, Japan
| | - Hiroki Kawashima
- Department of Endoscopy, Nagoya University Hospital, Aichi Prefecture, Nagoya 4668550, Japan
| | - Masanao Nakamura
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Aichi Prefecture, Nagoya 4668550, Japan
| | - Eizaburo Ohno
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Aichi Prefecture, Nagoya 4668550, Japan
| | - Takuya Ishikawa
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Aichi Prefecture, Nagoya 4668550, Japan
| | - Takeshi Yamamura
- Department of Endoscopy, Nagoya University Hospital, Aichi Prefecture, Nagoya 4668550, Japan
| | - Keiko Maeda
- Department of Endoscopy, Nagoya University Hospital, Aichi Prefecture, Nagoya 4668550, Japan
| | - Tsunaki Sawada
- Department of Endoscopy, Nagoya University Hospital, Aichi Prefecture, Nagoya 4668550, Japan
| | - Hiroyuki Tanaka
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Aichi Prefecture, Nagoya 4668550, Japan
| | - Daisuke Sakai
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Aichi Prefecture, Nagoya 4668550, Japan
| | - Ryoji Miyahara
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Aichi Prefecture, Nagoya 4668550, Japan
| | - Masatoshi Ishigami
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Aichi Prefecture, Nagoya 4668550, Japan
| | - Yoshiki Hirooka
- Department of Liver, Biliary Tract and Pancreas Diseases, Fujita Health University Hospital, Aichi Prefecture, Toyoake 4701192, Japan
| | - Mitsuhiro Fujishiro
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Aichi Prefecture, Nagoya 4668550, Japan
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