Case Control Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 7, 2015; 21(5): 1546-1553
Published online Feb 7, 2015. doi: 10.3748/wjg.v21.i5.1546
Passive-bending, short-type single-balloon enteroscope for endoscopic retrograde cholangiopancreatography in Roux-en-Y anastomosis patients
Hiroshi Yamauchi, Mitsuhiro Kida, Kosuke Okuwaki, Shiro Miyazawa, Tomohisa Iwai, Shuko Tokunaga, Miyoko Takezawa, Hiroshi Imaizumi, Wasaburo Koizumi
Hiroshi Yamauchi, Mitsuhiro Kida, Kosuke Okuwaki, Shiro Miyazawa, Tomohisa Iwai, Shuko Tokunaga, Miyoko Takezawa, Hiroshi Imaizumi, Wasaburo Koizumi, Department of Gastroenterology, Kitasato University East Hospital, Kanagawa 252-0380, Japan
Author contributions: Yamauchi H and Kida M designed the study; Yamauchi H and Okuwaki K performed the research; Yamauchi H, Kida M, Okuwaki K, Miyazawa S, Iwai T, Tokunaga S, Takezawa M and Imaizumi H contributed technical support; Kida M and Koizumi W critically revised the manuscript; Yamauchi H analyzed the data and wrote the paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Hiroshi Yamauchi, MD, Department of Gastroenterology, Kitasato University East Hospital, 2-1-1 Asamizodai, Minami-ku, Sagamihara, Kanagawa 252-0380, Japan. yhiroshi@kitasato-u.ac.jp
Telephone: +81-42-7489111 Fax: +81-42-7498690
Received: June 13, 2014
Peer-review started: June 16, 2014
First decision: July 21, 2014
Revised: July 29, 2014
Accepted: October 15, 2014
Article in press: October 15, 2014
Published online: February 7, 2015
Processing time: 240 Days and 20.2 Hours
Abstract

AIM: To evaluate short-type-single-balloon enteroscope (SBE) with passive-bending, high-force transmission functions for endoscopic retrograde cholangiopancreatography (ERCP) in patients with Roux-en-Y anastomosis.

METHODS: Short-type SBE with this technology (SIF-Y0004-V01; working length, 1520 mm; channel diameter, 3.2 mm) was used to perform 50 ERCP procedures in 37 patients with Roux-en-Y anastomosis. The rate of reaching the blind end, time required to reach the blind end, diagnostic and therapeutic success rates, and procedure time and complications were studied retrospectively and compared with the results of 34 sessions of ERCP performed using a short-type SBE without this technology (SIF-Y0004; working length, 1520 mm; channel diameter, 3.2 mm) in 25 patients.

RESULTS: The rate of reaching the blind end was 90% with SIF-Y0004-V01 and 91% with SIF-Y0004 (P = 0.59). The median time required to reach the papilla was significantly shorter with SIF-Y0004-V01 than with SIF-Y0004 (16 min vs 24 min, P = 0.04). The diagnostic success rate was 93% with SIF-Y0004-V01 and 84% with SIF-Y0004 (P = 0.17). The therapeutic success rate was 95% with SIF-Y0004-V01 and 96% with SIF-Y0004 (P = 0.68). The median procedure time was 40 min with SIF-Y0004-V01 and 36 min with SIF-Y0004 (P = 0.50). The incidence of hyperamylasemia was 6.0% in the SIF-Y0004-V01 group and 14.7% in the SIF-Y0004 group (P = 0.723). The incidence of pancreatitis was 0% in the SIF-Y0004-V01 group and 5.9% in the SIF-Y0004 group (P > 0.999). The incidence of gastrointestinal perforation was 2.0% (1/50) in the SIF-Y0004-V01 group and 2.9% (1/34) in the SIF-Y0004 group (P > 0.999).

CONCLUSION: SIF-Y0004-V01 is useful for ERCP in patients with Roux-en-Y anastomosis and may reduce the time required to reach the blind end.

Keywords: Passive bending; Roux-en-Y anastomosis; Endoscopic retrograde cholangiopancreatography; Short type; Single-balloon enteroscope

Core tip: We performed endoscopic retrograde cholangiopancreatography (ERCP) with a short-type single-balloon enteroscope with passive-bending and high-force transmission functions (working length, 1520 mm; channel diameter, 3.2 mm), and evaluated its effectiveness and compared results with normal short-type single-balloon enteroscope. This technology is expected to facilitate ERCP after intestinal reconstruction. In our study, the rate of reaching the blind end did not differ, however the median time required to reach the blind end was significantly shorter, and therefore this scope is useful for ERCP in patients with a Roux-en-Y anastomosis.