Study of factors influencing the insertion failure of single balloon enteroscopy-assisted ERCP treatment after bilioenteric Roux-en-Y anastomosis
Abstract Background and study aims Fail to reach the bilioenteric anastomosis is the main cause of treatment failure during single-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (SBE-assisted ERCP) in patients after bilioenteric Roux-en-Y anastomosis. We aim to evaluate...
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BMC
2025-03-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-025-03689-2 |
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| author | Weng Hao Fan Qingquan Gu Jun Weng Mingzhe Zhao Mingning Zhang Yi Xu Leiming Shu Yijun Wei Ding AWang Suo Lang Wang Xuefeng Song Xiaoling |
| author_facet | Weng Hao Fan Qingquan Gu Jun Weng Mingzhe Zhao Mingning Zhang Yi Xu Leiming Shu Yijun Wei Ding AWang Suo Lang Wang Xuefeng Song Xiaoling |
| author_sort | Weng Hao |
| collection | DOAJ |
| description | Abstract Background and study aims Fail to reach the bilioenteric anastomosis is the main cause of treatment failure during single-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (SBE-assisted ERCP) in patients after bilioenteric Roux-en-Y anastomosis. We aim to evaluate factors influencing the endoscopic insertion failure. Patients and methods We retrospectively reviewed the clinical data of 231 cases undergoing SBE-assisted ERCP from January 2016 to December 2021. Treatment details and outcomes were studied to analyze the factors involved in endoscopic insertion failure. Results The enteroscopy success rate and procedural success rate were 88.3% and 84.4%. Incidence of postoperative adverse events was 3.9%. No serious adverse events occurred. Risk factors of endoscopic insertion failure include first ERCP attempt, side to side anastomosis at the Rou-Y anastomosis, the use of Endo-GIA anastomosis, three bowel lumens seen at the Rou-Y anastomosis under endoscopy, steep angle of the afferent loop at the Rou-Y anastomosis with a U-shape, length of the afferent loop ≥ 50 cm, and twisted afferent loop. Among which the multifactorial analysis suggested that the presence of three bowel lumens at the Rou-Y anastomosis and twisted afferent loop were independent risk factors for enteroscopy failure. For case with twisted afferent loop, the use of a transparent cap with X-ray-assisted guidance during insertion is an effective strategy to improve the success rate. Conclusions SBE-assisted ERCP is safe and effective in patients after bilioenteric Roux-en-Y anastomosis. The severity of afferent loop twisting and Rou-Y anastomosis shape were risk factors for endoscopic insertion failure. Surgeons should take into account the feasibility of postoperative ERCP treatment at the time of operation. |
| format | Article |
| id | doaj-art-5e04b5f8002a4e33a7b29c80b1a440ed |
| institution | DOAJ |
| issn | 1471-230X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
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| series | BMC Gastroenterology |
| spelling | doaj-art-5e04b5f8002a4e33a7b29c80b1a440ed2025-08-20T02:41:32ZengBMCBMC Gastroenterology1471-230X2025-03-0125111010.1186/s12876-025-03689-2Study of factors influencing the insertion failure of single balloon enteroscopy-assisted ERCP treatment after bilioenteric Roux-en-Y anastomosisWeng Hao0Fan Qingquan1Gu Jun2Weng Mingzhe3Zhao Mingning4Zhang Yi5Xu Leiming6Shu Yijun7Wei Ding8AWang Suo Lang9Wang Xuefeng10Song Xiaoling11Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of MedicineDepartment of Hepatobiliary and Pancreatic Surgery, Shuguang Hospital, Affiliated to Shanghai University of Traditional Chinese MedicineDepartment of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of MedicineDepartment of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of MedicineDepartment of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of MedicineDepartment of Endoscopy Center, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of MedicineDepartment of Endoscopy Center, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of MedicineDepartment of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of MedicineDepartment of General Surgery, People’s Hospital of Shigatse CityDepartment of General Surgery, People’s Hospital of Shigatse CityDepartment of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of MedicineDepartment of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of MedicineAbstract Background and study aims Fail to reach the bilioenteric anastomosis is the main cause of treatment failure during single-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (SBE-assisted ERCP) in patients after bilioenteric Roux-en-Y anastomosis. We aim to evaluate factors influencing the endoscopic insertion failure. Patients and methods We retrospectively reviewed the clinical data of 231 cases undergoing SBE-assisted ERCP from January 2016 to December 2021. Treatment details and outcomes were studied to analyze the factors involved in endoscopic insertion failure. Results The enteroscopy success rate and procedural success rate were 88.3% and 84.4%. Incidence of postoperative adverse events was 3.9%. No serious adverse events occurred. Risk factors of endoscopic insertion failure include first ERCP attempt, side to side anastomosis at the Rou-Y anastomosis, the use of Endo-GIA anastomosis, three bowel lumens seen at the Rou-Y anastomosis under endoscopy, steep angle of the afferent loop at the Rou-Y anastomosis with a U-shape, length of the afferent loop ≥ 50 cm, and twisted afferent loop. Among which the multifactorial analysis suggested that the presence of three bowel lumens at the Rou-Y anastomosis and twisted afferent loop were independent risk factors for enteroscopy failure. For case with twisted afferent loop, the use of a transparent cap with X-ray-assisted guidance during insertion is an effective strategy to improve the success rate. Conclusions SBE-assisted ERCP is safe and effective in patients after bilioenteric Roux-en-Y anastomosis. The severity of afferent loop twisting and Rou-Y anastomosis shape were risk factors for endoscopic insertion failure. Surgeons should take into account the feasibility of postoperative ERCP treatment at the time of operation.https://doi.org/10.1186/s12876-025-03689-2Bilioenteric Roux-en-Y anastomosisSingle-balloon Enteroscope (SBE)Endoscopic retrograde cholangiopancreatography (ERCP)Biliary tract diseases |
| spellingShingle | Weng Hao Fan Qingquan Gu Jun Weng Mingzhe Zhao Mingning Zhang Yi Xu Leiming Shu Yijun Wei Ding AWang Suo Lang Wang Xuefeng Song Xiaoling Study of factors influencing the insertion failure of single balloon enteroscopy-assisted ERCP treatment after bilioenteric Roux-en-Y anastomosis BMC Gastroenterology Bilioenteric Roux-en-Y anastomosis Single-balloon Enteroscope (SBE) Endoscopic retrograde cholangiopancreatography (ERCP) Biliary tract diseases |
| title | Study of factors influencing the insertion failure of single balloon enteroscopy-assisted ERCP treatment after bilioenteric Roux-en-Y anastomosis |
| title_full | Study of factors influencing the insertion failure of single balloon enteroscopy-assisted ERCP treatment after bilioenteric Roux-en-Y anastomosis |
| title_fullStr | Study of factors influencing the insertion failure of single balloon enteroscopy-assisted ERCP treatment after bilioenteric Roux-en-Y anastomosis |
| title_full_unstemmed | Study of factors influencing the insertion failure of single balloon enteroscopy-assisted ERCP treatment after bilioenteric Roux-en-Y anastomosis |
| title_short | Study of factors influencing the insertion failure of single balloon enteroscopy-assisted ERCP treatment after bilioenteric Roux-en-Y anastomosis |
| title_sort | study of factors influencing the insertion failure of single balloon enteroscopy assisted ercp treatment after bilioenteric roux en y anastomosis |
| topic | Bilioenteric Roux-en-Y anastomosis Single-balloon Enteroscope (SBE) Endoscopic retrograde cholangiopancreatography (ERCP) Biliary tract diseases |
| url | https://doi.org/10.1186/s12876-025-03689-2 |
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