Copyright
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Aug 16, 2020; 12(8): 220-230
Published online Aug 16, 2020. doi: 10.4253/wjge.v12.i8.220
Which scope is appropriate for endoscopic retrograde cholangiopancreatography after Billroth II reconstruction: An esophagogastroduodenoscope or a colonoscope?
Mitsuru Sugimoto, Tadayuki Takagi, Rei Suzuki, Naoki Konno, Hiroyuki Asama, Yuki Sato, Hiroki Irie, Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Mika Takasumi, Minami Hashimoto, Tsunetaka Kato, Takuto Hikichi, Hiromasa Ohira
Mitsuru Sugimoto, Tadayuki Takagi, Rei Suzuki, Naoki Konno, Hiroyuki Asama, Yuki Sato, Hiroki Irie, Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Mika Takasumi, Hiromasa Ohira, Department of Gastroenterology, School of Medicine, Fukushima Medical University, Fukushima 9601247, Japan
Ko Watanabe, Jun Nakamura, Minami Hashimoto, Tsunetaka Kato, Takuto Hikichi, Department of Endoscopy, Fukushima Medical University Hospital, Fukushima 9601247, Japan
Author contributions: Sugimoto M designed and performed the study; Sugimoto M, Takagi T, and Ohira H analyzed the data; Sugimoto M, Takagi T, and Ohira H wrote the paper; Suzuki R, Konno N, Asama H, Hikichi T, Watanabe K, Nakamura J, Kikuchi H, Takasumi M, Sato Y, Hashimoto M, Kato T and Irie H provided clinical advice; and Hikichi T and Ohira H supervised the study.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Fukushima Medical University.
Informed consent statement: Patients were not required to provide informed consent for the study because the analysis used anonymous clinical data obtained after each patient agreed to treatment by written consent. For full disclosure, see the details of the study published on the home page of Fukushima Medical University.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Mitsuru Sugimoto, MD, PhD, Assistant Professor, Doctor, Department of Gastroenterology, Fukushima Medical University, School of Medicine, Hikarigaoka 1, Fukushima 9601295, Japan. kitachuuou335@yahoo.co.jp
Received: March 21, 2020
Peer-review started: March 21, 2020
First decision: April 25, 2020
Revised: May 19, 2020
Accepted: July 19, 2020
Article in press: July 19, 2020
Published online: August 16, 2020
Processing time: 144 Days and 18.4 Hours
BACKGROUND
Recently, with the advent of more advanced devices and endoscopic techniques, endoscopic retrograde cholangiopancreatography (ERCP) in Billroth II (B-II) patients has been increasingly performed. However, the procedures are difficult, and the techniques and strategies have not been defined.
AIM
To reveal the appropriate scope for ERCP in B-II patients.
METHODS
Sixty ERCP procedures were performed on B-II patients between June 2005 and May 2018 at Fukushima Medical University Hospital, and in 44 cases, this was the first ERCP procedure performed by esophagogastroduodenoscopy (EGDS) or colonoscopy (CS) after B-II gastrectomy. These cases were divided into two groups: 17 cases of ERCP performed by EGDS (EGDS group) and 27 cases of ERCP performed by CS (CS group). The patient characteristics and ERCP procedures were compared between the EGDS and CS groups.
RESULTS
The procedural time was significantly shorter in the EGDS group than in the CS group [median (range): 60 (20-100) vs 90 (40-128) min, P value < 0.01]. CS was an independent factor of a longer ERCP procedural time according to the univariate and multivariate analyses (odds ratio: 3.97, 95%CI: 1.05-15.0, P value = 0.04).
CONCLUSION
Compared to CS, EGDS shortened the procedural time of ERCP in B-II patients.
Core tip: This study aimed to reveal the appropriate scope for endoscopic retrograde cholangiopancreatography (ERCP) in Billroth II (B-II) patients. Sixty ERCP procedures were performed in B-II patients, and in 44 cases, this was the first ERCP procedure performed by esophagogastroduodenoscopy (EGDS) or colonoscopy (CS) after B-II gastrectomy. The procedural time was significantly shorter in the EGDS group than in the CS group. CS was an independent factor of a longer ERCP procedural time according to the univariate and multivariate analyses. Compared to CS, EGDS shortened the procedural time of ERCP in B-II patients.
