Publication: Current status of endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy
Issued Date
2019-07-14
Resource Type
ISSN
22192840
10079327
10079327
Other identifier(s)
2-s2.0-85070207911
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Mahidol University
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SCOPUS
Bibliographic Citation
World Journal of Gastroenterology. Vol.25, No.26 (2019), 3313-3333
Suggested Citation
Chonlada Krutsri, Mitsuhiro Kida, Hiroshi Yamauchi, Tomohisa Iwai, Hiroshi Imaizumi, Wasaburo Koizumi Current status of endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy. World Journal of Gastroenterology. Vol.25, No.26 (2019), 3313-3333. doi:10.3748/wjg.v25.i26.3313 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/51530
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Title
Current status of endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy
Abstract
©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved. Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy must be performed by a highly experienced endoscopist. The challenges are accessing the afferent limb in different types of reconstruction, cannulating a papilla with a reverse orientation, and performing therapeutic interventions with uncommon endoscopic accessories. The development of endoscopic techniques has led to higher success rates in this group of patients. Device-assisted ERCP is the endoscopic procedure of choice for high success rates in short-limb reconstruction; however, these success rate is lower in long-limb reconstruction. ERCP assisted by endoscopic ultrasonography is now popular because it can be performed independent of the limb length; however, it must be performed by a highly experienced and skilled endoscopist. Stent deployment and small stone removal can be performed immediately after ERCP assisted by endoscopic ultrasonography, but the second session is needed for other difficult procedures such as cholangioscopy-guided electrohydraulic lithotripsy. Laparoscopic-assisted ERCP has an almost 100% success rate in longlimb reconstruction because of the use of a conventional side-view duodenoscope, which is compatible with standard accessories. This requires cooperation between the surgeon and endoscopist and is suitable in urgent situations requiring concomitant cholecystectomy. This review focuses on the advantages, disadvantages, and outcomes of various procedures that are suitable in different situations and reconstruction types. Emerging new techniques and their outcomes are also discussed.