Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) is a well-described technique for diagnosis and treatment of hepatobiliary and pancreatic disorders. Spiral enteroscopy assisted ERCP (SE-ERCP) is a well-described technique for reaching and cannulating the ampulla and performing diagnostic and therapeutic interventions. The aim of the meta-analysis is to evaluate the procedural success rate of SE-ERCP in patients with altered upper gastrointestinal anatomy. A search was conducted in Medline, Pubmed, and Ovid and extracted data into an abstraction form. Meta-analysis for success rates was analyzed by calculating pooled proportion with inverse variance. A total of 172 SE-ERCPs were included in this analysis from five relevant studies. The pooled success rate of reaching the ampulla by spiral enteroscopy was 75%. SE-ERCP is a viable technique for diagnostic and therapeutic intervention of biliary disorders.
Highlights
In patients with altered anatomy endoscopic retrograde cholangiopancreatography (ERCP) can be technically challenging and difficult to perform especially with cannulation of the biliopancreatic system
ERCP is more difficult to perform in patients with altered anatomy
The search was performed using a combination of search terms: “Spiral enteroscopy ERCP” or “ERCP in altered anatomy”
Summary
In patients with altered anatomy endoscopic retrograde cholangiopancreatography (ERCP) can be technically challenging and difficult to perform especially with cannulation of the biliopancreatic system. Experienced therapeutic endoscopists have increased the success rates and decreased complications rates over the past several years. As other alternative diagnostic modalities have developed, such as magnetic retrograde cholangiopancreatography (MRCP), ERCP has evolved to become predominately a therapeutic endoscopic procedure [1]. As the rates of obesity continue to rise, so have the rates of bariatric surgeries Rouxen-Y gastric bypass. These particular patients are even more susceptible to choledocholithiasis and other bile duct strictures. ERCP is more difficult to perform in patients with altered anatomy
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