Published online Nov 14, 2020. doi: 10.3748/wjg.v26.i42.6669
Peer-review started: August 17, 2020
First decision: September 12, 2020
Revised: September 14, 2020
Accepted: September 23, 2020
Article in press: September 23, 2020
Published online: November 14, 2020
Double-balloon endoscopic retrograde cholangiography (DBERC) has been widely used for pancreatobiliary diseases after reconstruction in gastrointestinal surgery, but sometimes it is complicating.
The accurate selection of the route at the anastomosis branch is one of the most important factors for the success of DBERC. We used carbon dioxide insufflation enterography (CDE) for selecting the route.
The aim of this study was to determine the accuracy of CDE at the branch for selecting the correct route during DBERC.
Route selection via two methods (visual observation and CDE) was performed in each patient in DBERC. We determined the correct rate of route selection using CDE. The primary endpoint was the correct rate of CDE for selection of the route to the target. Secondary endpoints were the comparison of correct rate between visual observation and CDE around the anastomosis and examination times.
We enrolled 52 consecutive patients scheduled for DBERC at our institution from June 2015 to November 2017. We were able to reach the target in 50/52 patients. The rate of correct route selection using visual observation and CDE were 36/52 (69.2%) and 48/52 (92.3%), respectively (P = 0.002). The rate of correct route selection using CDE in patients with a jejunojejunal anastomosis was 29/33 (87.8%), and the rate in patients with a gastrojejunal anastomosis was 19/19 (100%).
CDE was able to accurately select the route at the anastomosis in patients with gastrointestinal reconstruction who are undergoing DBERC.
Using CDE, DBERC will be performed safely and easily for patients who underwent any gastrointestinal reconstruction. A randomized, comparative study between CDE and visual observation for the proper route selection is necessary.