Endoscopic approaches to biliary intervention in patients with surgically altered gastroduodenal anatomy

Table 1 Data from studies that evaluated the efficacy of single-balloon and double-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography in patients with surgically altered gastroduodenal anatomy

Ref.	Method	Cases (n)	Cases withRY-anatomy	Reached ampulla/orifice	Diagnostic ERCP success	Therapeutic ERCP success
Wang et al[22]	SBE	16	12	81.3%	100%	90%
Saleem et al[13]	SBE	56	56	75%	92.8%	91%
Itoi et al[17]	SBE1	13	11	92.3%	N/A	83.3%
Shah et al[3]	SBE	45	N/A	69%	87%2	87%2
Yamauchi et al[16]	Short SBE	31	23	90%	89%	96%
Shah et al[3]	DBE	27	N/A	74%	85%2	85%2
Aabakken et al[41]	DBE	18	18	94.4%	88%	100%
Emmett et al[42]	DBE	20	20	85%	94.1%	100%
Pohl et al[43]	DBE	25	25	95.5%	N/A	88.0%
Raithel et al[9]	DBE	86	29	74.1%	91.3%2	91.3%2
Shimatani et al[44]	Short DBE	103	81	97.1%	98.0%	100%
Itoi et al[15]	Short and Long DBE3	134	13	100%	66.7%	100%
Cho et al[45]	Short DBE	29	13	86.2%	96%	100%
Osoegawa et al[14]	Short DBE	47	29	96%	89%	100%
Siddiqui et al[46]	Short DBE	79	51	89.9%	90%	100%

¹After the papilla was reached with the single-balloon enteroscope, it was replaced with a conventional forward-viewing upper gastrointestinal endoscope;

²Reported success was for both diagnostic and therapeutic procedures;

³For long double-balloon enteroscopy (DBE) cases, after the papilla was reached with the balloon enteroscope, it was replaced with a conventional forward-viewing gastroscope;

⁴Of 13 total cases, 5 patients underwent long DBE and 4 patients underwent short DBE. Diagnostic success rates were calculated only for those patients in whom the ampulla/orifice was reached. Therapeutic success rates do not include those patients in whom the ampulla/orifice was not reached and/or diagnostic endoscopic retrograde cholangiopancreatography (ERCP) failed or patients who did not require any therapeutic intervention. SBE: Single-balloon enteroscopy. RY: Roux-en-Y.

Table 2 Reported rates of adverse events in patients with surgically altered gastroduodenal anatomy who underwent deep-enteroscopy-assisted endoscopic retrograde cholangiopancreatography

Ref.	Method	Cases (n)	Cases with RY anatomy	Pancreatitis	All adverse events
Wang et al[22]	SBE	16	12	12.5%	12.5%
Saleem et al[13]	SBE	56	56	0%	0%
Itoi et al[17]	SBE	13	11	0%	0%
Yamauchi et al[16]	Short SBE	31	23	7.7%	N/A
Emmett et al[42]	DBE	20	20	0%	0%
Raithel et al[9]	DBE	86	34	2.3%	N/A
Shimatani et al[44]	Short DBE	103	81	0%	4.9%
Itoi et al[15]	Long and short DBE	13	13	0%	7.7%
Siddiqui et al[46]	Short DBE	79	51	4%	5%
Lennon et al[4]	Spiral	29	29	0%	0%
Wagh et al[47]	Spiral	57	6 of 7 pts	0%	0%

DBE: Double-balloon enteroscopy; SBE: Single-balloon enteroscopy; RY: Roux-en-Y.

Table 3 Studies that evaluated the efficacy of spiral-enteroscopy-assisted endoscopic retrograde cholangiopancreatography in patients with surgically altered gastroduodenal anatomy

Ref.	Method	Cases (n)	Cases with RY anatomy	Reached ampulla/orifice	Diagnostic ERCP success	Therapeutic ERCP success
Shah et al[3]	Spiral	57	N/A	72%	90%1	90%1
Lennon et al[4]	Spiral	29	29	N/A	40%	87.5%
Wagh et al[47]	Spiral	13	6 of 7 patients	77%	89%	90%

¹Reported success was for both diagnostic and therapeutic procedures. Diagnostic success rates were calculated only for those patients in whom the ampulla/orifice was reached. Therapeutic success rates do not include those patients in whom the ampulla/orifice was not reached and/or diagnostic endoscopic retrograde cholangiopancreatography (ERCP) failed or patients who did not require any therapeutic intervention. RY: Roux-en-Y.