Endoscopic entero-enteral bypass: an effective new approach to the treatment of postsurgical complications of hepaticojejunostomy.
Endoscopy
; 51(12): 1146-1150, 2019 12.
Article
em En
| MEDLINE
| ID: mdl-31163496
ABSTRACT
BACKGROUND:
Management of biliary adverse events (BAEs) after biliodigestive anastomosis is challenging. We propose a new endoscopic approach to improve BAEs in this clinical setting.METHODS:
Patients who had BAEs after a hepaticojejunostomy with Roux-en-Y loop or a Whipple procedure underwent creation of an entero-enteral endoscopic bypass (EEEB) between the duodenal/gastric wall and the biliary jejunal loop under endoscopic ultrasound (EUS) and fluoroscopic guidance using specifically designed fully covered self-expandable metal stents.RESULTS:
32 consecutive patients underwent EEEB, which was successful in all but one patient. One procedural and five long-term mild adverse events occurred. Endoscopic retrograde cholangiography (ERC) through the EEEB successfully treated all types of BAEs in these patients. Disease recurred in two patients who were successfully re-treated through the EEEB.CONCLUSIONS:
Our retrospective study showed that in patients with BAEs after biliodigestive anastomosis, EEEB is safe, feasible, and allows a successful long-term treatment of different BAEs in a tertiary referral center with high-level experience in both endoscopic retrograde cholangiopancreatography and EUS.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Anastomose em-Y de Roux
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Anastomose Cirúrgica
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Procedimentos Cirúrgicos do Sistema Biliar
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Endoscopia Gastrointestinal
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Colangiopancreatografia Retrógrada Endoscópica
Tipo de estudo:
Diagnostic_studies
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Guideline
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Observational_studies
/
Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Endoscopy
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Itália