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Obesity Surgery
Published in: Obesity Surgery 1/2021

01-01-2021 | Gastrostomy | Original Contributions

Procedural Outcomes of Laparoscopic-Assisted Endoscopic Retrograde Cholangiopancreatography in Patients with Previous Roux-en-Y Gastric Bypass Surgery: a Systematic Review and Meta-analysis

Authors: Shahab Hajibandeh, Shahin Hajibandeh, Munir Tarazi, Moustafa Mansour, Thomas Satyadas

Published in: Obesity Surgery | Issue 1/2021

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Abstract

Purpose

To investigate the procedural outcomes of laparoscopic-assisted endoscopic retrograde cholangiopancreatography (ERCP) in patients with previous Roux-en-Y gastric bypass (RYGB) surgery.

Materials and Methods

We performed a systematic review in accordance with PRISMA statement standards to identify all studies reporting procedural outcomes of laparoscopic-assisted ERCP in patients with previous RYGB. The ROBINS-I tool was used to assess the risk of bias of the included studies. Fixed-effect and random-effects models were applied to calculate pooled outcome data.

Results

A total of 17 case series, enrolling 256 patients, were included. The mean age of included patients was 49. The mean procedure time was 137 min (95% CI 102–172). In terms of procedural success rates, the overall technical success was 95.3% (95% CI 92.5–97.5, I2 = 0%), papillary access success was 95.3% (95% CI 92.5–97.5, I2 = 0%), cannulation success was 95.3% (95% CI 92.5–97.5, I2 = 0%), sphincterotomy success was 96.1% (95% CI 93.5–98.1, I2 = 0%), and stone removal success was 95.9% (95% CI 92.4–98.4, I2 = 0%). Conversion to open was required in 4.7% (95% CI 2.5–7.6, I2 = 0%). In terms of complications, pancreatitis occurred in 4.7% (95% CI 2.3–8, I2 = 17%), cholangitis in 1.7% (95% CI 0.5–3.6, I2 = 0%), and perforation in 3.7% (95% CI 1.8–6.3, I2 = 0%). The length of hospital stay was 3 days (95% CI 2–4).

Conclusions

Laparoscopic-assisted ERCP seems to be feasible, effective, and a safe method to access the biliary tract in patients with previous RYGB as indicated by high technical success rates and low complication rates. There is a need for comparative evidence regarding outcomes of laparoscopic ERCP in comparison with alternative treatment options.
Appendix
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Metadata
Title
Procedural Outcomes of Laparoscopic-Assisted Endoscopic Retrograde Cholangiopancreatography in Patients with Previous Roux-en-Y Gastric Bypass Surgery: a Systematic Review and Meta-analysis
Authors
Shahab Hajibandeh
Shahin Hajibandeh
Munir Tarazi
Moustafa Mansour
Thomas Satyadas
Publication date
01-01-2021
Publisher
Springer US
Published in
Obesity Surgery / Issue 1/2021
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-020-04954-x

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