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Efficacy and factors affecting procedure results of short-type single-balloon enteroscopy–assisted ERCP for altered anatomy: a multicenter cohort in Japan
Gastrointestinal Endoscopy ( IF 6.7 ) Pub Date : 2021-09-14 , DOI: 10.1016/j.gie.2021.09.008 Yuki Tanisaka 1 , Shomei Ryozawa 1 , Takao Itoi 2 , Hiroshi Yamauchi 3 , Akio Katanuma 4 , Yoshinobu Okabe 5 , Atsushi Irisawa 6 , Kazunari Nakahara 7 , Eisuke Iwasaki 8 , Kentaro Ishii 2 , Toshifumi Kin 4 , Hiroya Terabe 5 , Naoya Izawa 6 , Ryo Morita 7 , Kazuhiro Minami 8 , Ryuichiro Araki 9 , Akashi Fujita 1 , Tomoya Ogawa 1 , Masafumi Mizuide 1 , Mitsuhiro Kida 3
Gastrointestinal Endoscopy ( IF 6.7 ) Pub Date : 2021-09-14 , DOI: 10.1016/j.gie.2021.09.008 Yuki Tanisaka 1 , Shomei Ryozawa 1 , Takao Itoi 2 , Hiroshi Yamauchi 3 , Akio Katanuma 4 , Yoshinobu Okabe 5 , Atsushi Irisawa 6 , Kazunari Nakahara 7 , Eisuke Iwasaki 8 , Kentaro Ishii 2 , Toshifumi Kin 4 , Hiroya Terabe 5 , Naoya Izawa 6 , Ryo Morita 7 , Kazuhiro Minami 8 , Ryuichiro Araki 9 , Akashi Fujita 1 , Tomoya Ogawa 1 , Masafumi Mizuide 1 , Mitsuhiro Kida 3
Affiliation
Although single-balloon enteroscopy (SBE)-assisted or short-type SBE (short SBE)-assisted ERCP has been reported as useful in patients with surgically altered anatomy, most studies had small sample sizes or single-center designs. This study aimed to evaluate the efficacy and factors affecting the procedure results of short SBE–assisted ERCP in patients with surgically altered anatomy. This multicenter, retrospective study was conducted at 8 tertiary referral care centers in Japan. The data of patients who underwent ERCP-related procedures using short SBE between September 2011 and August 2019 at each facility were analyzed. Overall, 1318 patients were included in this analysis. The enteroscopy (reaching the target site), cannulation, and total procedural success rates were 87.9% (95% confidence interval [CI], 86.1%-89.6%), 87.0% (95% CI, 84.9%-88.8%), and 74.9% (95% CI, 72.5%-77.2%), respectively. Adverse events occurred in 7.7% of patients (95% CI, 6.4%-9.3%). Multiple logistic regression analysis indicated that age (≥75 years), Roux-en-Y reconstruction, pancreatic indication, and malignancy were factors affecting the total procedural failure. This large-scale study proved that short SBE–assisted ERCP in patients with surgically altered anatomy was effective. Moreover, it clarified factors affecting procedure results. Proficiency with alternative treatment techniques is required in difficult cases. (Clinical trial registration number: UMIN00004045.)
中文翻译：
短型单球囊肠镜辅助 ERCP 改变解剖结构的疗效和影响手术结果的因素：日本多中心队列
尽管单球囊肠镜 (SBE) 辅助或短型 SBE (短 SBE) 辅助 ERCP 据报道对手术改变解剖结构的患者有用，但大多数研究样本量较小或单中心设计。本研究旨在评估短期 SBE 辅助 ERCP 对手术改变解剖结构的患者的疗效和影响手术结果的因素。这项多中心回顾性研究是在日本 8 个三级转诊护理中心进行的。对 2011 年 9 月至 2019 年 8 月期间在各机构使用短 SBE 接受 ERCP 相关手术的患者数据进行了分析。总体而言，本次分析纳入了 1318 名患者。肠镜检查（到达目标部位）、插管和总手术成功率分别为 87.9%（95% 置信区间 [CI]，86.1%-89.6%）、87.0%（95% CI，84.9%-88.8%）和分别为 74.9%（95% CI，72.5%-77.2%）。 7.7% 的患者发生不良事件（95% CI，6.4%-9.3%）。多元logistic回归分析表明年龄（≥75岁）、Roux-en-Y重建、胰腺指征和恶性肿瘤是影响手术总失败的因素。这项大规模研究证明，短期 SBE 辅助 ERCP 对于手术改变解剖结构的患者是有效的。此外，它澄清了影响程序结果的因素。在困难的情况下需要熟练掌握替代治疗技术。 （临床试验注册号：UMIN00004045。）
更新日期：2021-09-14
中文翻译：
短型单球囊肠镜辅助 ERCP 改变解剖结构的疗效和影响手术结果的因素：日本多中心队列
尽管单球囊肠镜 (SBE) 辅助或短型 SBE (短 SBE) 辅助 ERCP 据报道对手术改变解剖结构的患者有用，但大多数研究样本量较小或单中心设计。本研究旨在评估短期 SBE 辅助 ERCP 对手术改变解剖结构的患者的疗效和影响手术结果的因素。这项多中心回顾性研究是在日本 8 个三级转诊护理中心进行的。对 2011 年 9 月至 2019 年 8 月期间在各机构使用短 SBE 接受 ERCP 相关手术的患者数据进行了分析。总体而言，本次分析纳入了 1318 名患者。肠镜检查（到达目标部位）、插管和总手术成功率分别为 87.9%（95% 置信区间 [CI]，86.1%-89.6%）、87.0%（95% CI，84.9%-88.8%）和分别为 74.9%（95% CI，72.5%-77.2%）。 7.7% 的患者发生不良事件（95% CI，6.4%-9.3%）。多元logistic回归分析表明年龄（≥75岁）、Roux-en-Y重建、胰腺指征和恶性肿瘤是影响手术总失败的因素。这项大规模研究证明，短期 SBE 辅助 ERCP 对于手术改变解剖结构的患者是有效的。此外，它澄清了影响程序结果的因素。在困难的情况下需要熟练掌握替代治疗技术。 （临床试验注册号：UMIN00004045。）
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