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Open Access 07-03-2024 | Endoscopic Retrograde Cholangiopancreatography

Balloon endoscopy-assisted endoscopic retrograde cholangiopancreatography for hepatolithiasis in patients with hepaticojejunostomy

Authors: Ryunosuke Hakuta, Tatsuya Sato, Yousuke Nakai, Hirofumi Kogure, Hiroto Nishio, Kouhei Kurihara, Shuichi Tange, Rintaro Fukuda, Shinya Takaoka, Yukari Suzuki, Hiroki Oyama, Sachiko Kanai, Kensaku Noguchi, Tatsunori Suzuki, Kazunaga Ishigaki, Tomotaka Saito, Tsuyoshi Hamada, Naminatsu Takahara, Mitsuhiro Fujishiro

Published in: Surgical Endoscopy | Issue 5/2024

Abstract

Background and aim

Balloon endoscopy-assisted endoscopic retrograde cholangiopancreatography (BE-ERCP) is an emerging procedure for pancreatobiliary diseases in patients with surgically altered anatomy. However, data on BE-ERCP for hepatolithiasis after hepaticojejunostomy (HJS) are still limited.

Methods

Stone removal success, adverse events and recurrence were retrospectively studied in consecutive patients who underwent BE-ERCP for hepatolithiasis after HJS between January 2011 and October 2022. Subgroup analysis was performed to compare clinical outcomes between patients who had undergone HJS over 10 years before (past HJS group) and within 10 years (recent HJS group).

Results

A total of 131 patients were included; 39% had undergone HJS for malignancy and 32% for congenital biliary dilation. Scope insertion and complete stone removal were successful in 89% and 73%, respectively. Early adverse events were observed in 9.9%. Four patients (3.1%) developed gastrointestinal perforation but could be managed conservatively. Hepatolithiasis recurrence rate was 17%, 20% and 31% in 1-year, 3-year, and 5-year after complete stone removal. The past HJS group was the only risk factor for failed stone removal (odds ratio 10.4, 95% confidence interval 2.99–36.5) in the multivariable analysis. Failed scope insertion (20%) and failed guidewire or device insertion to the bile duct (22%) were two major reasons for failed stone removal in the past HJS group.

Conclusions

BE-ERCP for hepatolithiasis was effective and safe in cases with HJS but the complete stone removal rate was low in the past HJS group. Recurrent hepatolithiasis was common and careful follow up study is needed even after complete stone removal.

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Title: Balloon endoscopy-assisted endoscopic retrograde cholangiopancreatography for hepatolithiasis in patients with hepaticojejunostomy
Authors: Ryunosuke Hakuta
Tatsuya Sato
Yousuke Nakai
Hirofumi Kogure
Hiroto Nishio
Kouhei Kurihara
Shuichi Tange
Rintaro Fukuda
Shinya Takaoka
Yukari Suzuki
Hiroki Oyama
Sachiko Kanai
Kensaku Noguchi
Tatsunori Suzuki
Kazunaga Ishigaki
Tomotaka Saito
Tsuyoshi Hamada
Naminatsu Takahara
Mitsuhiro Fujishiro
Publication date: 07-03-2024
Publisher: Springer US
Keywords: Endoscopic Retrograde Cholangiopancreatography
Endoscopy
Published in: Surgical Endoscopy / Issue 5/2024
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-024-10738-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Balloon endoscopy-assisted endoscopic retrograde cholangiopancreatography for hepatolithiasis in patients with hepaticojejunostomy

Abstract

Background and aim

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background and aim

Methods

Results

Conclusions

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