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Long‐term outcomes after therapeutic endoscopic retrograde cholangiopancreatography using balloon‐assisted enteroscopy for anastomotic stenosis of choledochojejunostomy/pancreaticojejunostomy
Author(s) -
Sano Itsuki,
Katanuma Akio,
Kuwatani Masaki,
Kawakami Hiroshi,
Kato Hironari,
Itoi Takao,
Ono Michihiro,
Irisawa Atsushi,
Okabe Yoshinobu,
Iwashita Takuji,
Yasuda Ichiro,
Ryozawa Shomei,
Kaino Seiji,
Sakamoto Naoya
Publication year - 2019
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14605
Subject(s) - medicine , endoscopic retrograde cholangiopancreatography , anastomosis , balloon dilation , surgery , stenosis , restenosis , balloon , retrospective cohort study , radiology , stent , pancreatitis
Background and Aim Data on long‐term outcomes after therapeutic endoscopic retrograde cholangiopancreatography (ERCP) using balloon‐assisted enteroscopy (BAE) for choledochojejunal anastomotic stenosis (CJS) or pancreaticojejunal anastomotic stenosis (PJS) remain limited. We retrospectively assessed the long‐term results of patients who achieved clinical success using BAE for CJS and PJS. Methods Patients who achieved technical and clinical success for CJS or PJS by BAE‐ERCP and were followed up for more than 6 months after the initial BAE‐ERCP therapy were retrospectively identified at 11 Japanese institutions. The primary end‐point was CJS or PJS recurrence rates. The secondary end‐points were initial therapy details, initial therapy complications, and CJS or PJS recurrence treatment details. We also evaluated restenosis‐associated factors. Results From September 2008 to December 2015, 67 patients (CJS, 61; PJS, six) were included. The overall CJS and PJS recurrence rates were 34.4% and 33.3%, respectively. The 1‐year CJS recurrence rate was 18.5% (95% confidence interval, 10.7–31.0). Of all the patients, 88.1% underwent balloon dilation at the anastomotic stenosis site; stent placement was performed in 15 of 67 patients (22.4%). The complication rate was 8.2% in CJS and 0% in PJS. In patients who underwent balloon dilation, “remaining waist” was significantly associated with CJS recurrence after anastomotic balloon dilation ( P = 0.001). Conclusions The long‐term outcomes of BAE‐ERCP were comparable with those of percutaneous transhepatic treatment or surgical re‐anastomosis.