TY - JOUR
T1 - ERCP using balloon-assisted endoscopes versus EUS-guided treatment for common bile duct stones in Roux-en-Y gastrectomy
AU - Sato, Tatsuya
AU - Nakai, Yousuke
AU - Kogure, Hirofumi
AU - Mitsuyama, Toshiyuki
AU - Shimatani, Masaaki
AU - Uemura, Shinya
AU - Iwashita, Takuji
AU - Tanisaka, Yuki
AU - Ryozawa, Shomei
AU - Tsuchiya, Takayoshi
AU - Itoi, Takao
AU - Kin, Toshifumi
AU - Katanuma, Akio
AU - Kashima, Ken
AU - Irisawa, Atsushi
AU - Kayashima, Atsuto
AU - Iwasaki, Eisuke
AU - Yoshida, Akihiro
AU - Takenaka, Mamoru
AU - Himei, Hitomi
AU - Kato, Hironari
AU - Masuda, Atsuhiro
AU - Shiomi, Hideyuki
AU - Kawakubo, Kazumichi
AU - Kuwatani, Masaki
AU - Otsuka, Takeshi
AU - Matsubara, Saburo
AU - Nishioka, Nobu
AU - Ogura, Takeshi
AU - Tamura, Takaaki
AU - Kitano, Masayuki
AU - Hayashi, Nobuhiko
AU - Yasuda, Ichiro
AU - Fujishiro, Mitsuhiro
N1 - Publisher Copyright:
© 2024 American Society for Gastrointestinal Endoscopy
PY - 2024/2
Y1 - 2024/2
N2 - Background and Aims: We compared ERCP using a balloon-assisted endoscope (BE-ERCP) with EUS-guided antegrade treatment (EUS-AG) for removal of common bile duct (CBD) stones in patients with Roux-en-Y (R-Y) gastrectomy. Methods: Consecutive patients who had previous R-Y gastrectomy undergoing BE-ERCP or EUS-AG for CBD stones in 16 centers were retrospectively analyzed. Results: BE-ERCP and EUS-AG were performed in 588 and 59 patients, respectively. Baseline characteristics were similar, except for CBD diameter and angle. The technical success rate was 83.7% versus 83.1% (P = .956), complete stone removal rate was 78.1% versus 67.8% (P = .102), and early adverse event rate was 10.2% versus 18.6% (P = .076) in BE-ERCP and EUS-AG, respectively. The mean number of endoscopic sessions was smaller in BE-ERCP (1.5 ± .8 vs 1.9 ± 1.0 sessions, P = .01), whereas the median total treatment time was longer (90 vs 61.5 minutes, P = .001). Among patients with biliary access, the complete stone removal rate was significantly higher in BE-ERCP (93.3% vs 81.6%, P = .009). Negative predictive factors were CBD diameter ≥15 mm (odds ratio [OR], .41) and an angle of CBD <90 degrees (OR, .39) in BE-ERCP and a stone size ≥10 mm (OR, .07) and an angle of CBD <90 degrees (OR, .07) in EUS-AG. The 1-year recurrence rate was 8.3% in both groups. Conclusions: Effectiveness and safety of BE-ERCP and EUS-AG were comparable in CBD stone removal for patients after R-Y gastrectomy, but complete stone removal after technical success was superior in BE-ERCP.
AB - Background and Aims: We compared ERCP using a balloon-assisted endoscope (BE-ERCP) with EUS-guided antegrade treatment (EUS-AG) for removal of common bile duct (CBD) stones in patients with Roux-en-Y (R-Y) gastrectomy. Methods: Consecutive patients who had previous R-Y gastrectomy undergoing BE-ERCP or EUS-AG for CBD stones in 16 centers were retrospectively analyzed. Results: BE-ERCP and EUS-AG were performed in 588 and 59 patients, respectively. Baseline characteristics were similar, except for CBD diameter and angle. The technical success rate was 83.7% versus 83.1% (P = .956), complete stone removal rate was 78.1% versus 67.8% (P = .102), and early adverse event rate was 10.2% versus 18.6% (P = .076) in BE-ERCP and EUS-AG, respectively. The mean number of endoscopic sessions was smaller in BE-ERCP (1.5 ± .8 vs 1.9 ± 1.0 sessions, P = .01), whereas the median total treatment time was longer (90 vs 61.5 minutes, P = .001). Among patients with biliary access, the complete stone removal rate was significantly higher in BE-ERCP (93.3% vs 81.6%, P = .009). Negative predictive factors were CBD diameter ≥15 mm (odds ratio [OR], .41) and an angle of CBD <90 degrees (OR, .39) in BE-ERCP and a stone size ≥10 mm (OR, .07) and an angle of CBD <90 degrees (OR, .07) in EUS-AG. The 1-year recurrence rate was 8.3% in both groups. Conclusions: Effectiveness and safety of BE-ERCP and EUS-AG were comparable in CBD stone removal for patients after R-Y gastrectomy, but complete stone removal after technical success was superior in BE-ERCP.
UR - https://www.scopus.com/pages/publications/85182578155
U2 - 10.1016/j.gie.2023.09.001
DO - 10.1016/j.gie.2023.09.001
M3 - 学術論文
C2 - 37709151
AN - SCOPUS:85182578155
SN - 0016-5107
VL - 99
SP - 193-203.e5
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
IS - 2
ER -