Emergent treatment using balloon-assisted ERCP versus EUS-guided drainage for acute cholangitis in patients with surgically altered anatomy
Background : No studies have compared balloon-assisted endoscope-guided endoscopic retrograde cholangiopancreatography (BAE-ERCP) and endoscopic ultrasonography-guided biliary drainage (EUS-BD) for emergent treatment of acute cholangitis (AC) in patients with upper gastrointestinal surgically altere...
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Society of Gastrointestinal Intervention
2025-01-01
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| Series: | International Journal of Gastrointestinal Intervention |
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| Online Access: | https://www.ijgii.org/journal/view.html?doi=10.18528/ijgii240070 |
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| author | Takahiro Shishimoto Masahiro Itonaga Reiko Ashida Yasunobu Yamashita Yuki Kawaji Takashi Tamura Hiromu Morishita Akiya Nakahata Yuto Sugihara Tomokazu Ishihara Masayuki Kitano |
| author_facet | Takahiro Shishimoto Masahiro Itonaga Reiko Ashida Yasunobu Yamashita Yuki Kawaji Takashi Tamura Hiromu Morishita Akiya Nakahata Yuto Sugihara Tomokazu Ishihara Masayuki Kitano |
| author_sort | Takahiro Shishimoto |
| collection | DOAJ |
| description | Background : No studies have compared balloon-assisted endoscope-guided endoscopic retrograde cholangiopancreatography (BAE-ERCP) and endoscopic ultrasonography-guided biliary drainage (EUS-BD) for emergent treatment of acute cholangitis (AC) in patients with upper gastrointestinal surgically altered anatomy (SAA). Methods : This study retrospectively evaluated consecutive patients who underwent emergent BAE-ERCP or EUS-BD for AC with SAA between January 2020 and March 2024. Technical success, clinical success, procedure time, and adverse events (AEs) were compared between the two groups. Results : This study included 23 patients in the BAE-ERCP group and 14 patients in the EUS-BD group. Technical success and clinical success rates did not significantly differ between the two groups (88% vs. 100%, P=0.51 and 95% vs. 93%, P=0.66). Similarly, the rate of AEs was comparable between the two groups (4% vs. 14%, P=0.54). The median procedure time was significantly shorter in the EUS-BD group than in the BAE-ERCP group (32.5 [interquartile range; IQR, 28.8-52.5] minutes vs. 70.0 [IQR, 60.0-90.0] minutes, P<0.01). In cases with grade 2 or 3 cholangitis, the rates of technical success, clinical success, and AEs did not significantly differ between the two groups. However, the median procedure time was significantly shorter in the EUS-BD group than in the BAE-ERCP group (32.5 [IQR, 28.8-52.5] minutes vs. 70 [IQR, 56.3-90.0] minutes, P<0.01). Conclusion : While both BAE-ERCP and EUS-BD can be performed safely and effectively in patients with AC and SAA, the procedure time is significantly shorter with EUS-BD than with BAE-ERCP. |
| format | Article |
| id | doaj-art-828063a67de9410eb148733356c6fa82 |
| institution | Kabale University |
| issn | 2636-0004 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Society of Gastrointestinal Intervention |
| record_format | Article |
| series | International Journal of Gastrointestinal Intervention |
| spelling | doaj-art-828063a67de9410eb148733356c6fa822025-01-22T15:13:37ZengSociety of Gastrointestinal InterventionInternational Journal of Gastrointestinal Intervention2636-00042025-01-011412810.18528/ijgii240070ijgii240070Emergent treatment using balloon-assisted ERCP versus EUS-guided drainage for acute cholangitis in patients with surgically altered anatomyTakahiro Shishimoto0Masahiro Itonaga1Reiko Ashida2Yasunobu Yamashita3Yuki Kawaji4Takashi Tamura5Hiromu Morishita6Akiya Nakahata7Yuto Sugihara8Tomokazu Ishihara9Masayuki Kitano10Second Department of Internal Medicine, Wakayama Medical University, Wakayama, JapanSecond Department of Internal Medicine, Wakayama Medical University, Wakayama, JapanSecond Department of Internal Medicine, Wakayama Medical University, Wakayama, JapanSecond Department of Internal Medicine, Wakayama Medical University, Wakayama, JapanSecond Department of Internal Medicine, Wakayama Medical University, Wakayama, JapanSecond Department of Internal Medicine, Wakayama Medical University, Wakayama, JapanSecond Department of Internal Medicine, Wakayama Medical University, Wakayama, JapanSecond Department of Internal Medicine, Wakayama Medical University, Wakayama, JapanSecond Department of Internal Medicine, Wakayama Medical University, Wakayama, JapanSecond Department of Internal Medicine, Wakayama Medical University, Wakayama, JapanSecond Department of Internal Medicine, Wakayama Medical University, Wakayama, JapanBackground : No studies have compared balloon-assisted endoscope-guided endoscopic retrograde cholangiopancreatography (BAE-ERCP) and endoscopic ultrasonography-guided biliary drainage (EUS-BD) for emergent treatment of acute cholangitis (AC) in patients with upper gastrointestinal surgically altered anatomy (SAA). Methods : This study retrospectively evaluated consecutive patients who underwent emergent BAE-ERCP or EUS-BD for AC with SAA between January 2020 and March 2024. Technical success, clinical success, procedure time, and adverse events (AEs) were compared between the two groups. Results : This study included 23 patients in the BAE-ERCP group and 14 patients in the EUS-BD group. Technical success and clinical success rates did not significantly differ between the two groups (88% vs. 100%, P=0.51 and 95% vs. 93%, P=0.66). Similarly, the rate of AEs was comparable between the two groups (4% vs. 14%, P=0.54). The median procedure time was significantly shorter in the EUS-BD group than in the BAE-ERCP group (32.5 [interquartile range; IQR, 28.8-52.5] minutes vs. 70.0 [IQR, 60.0-90.0] minutes, P<0.01). In cases with grade 2 or 3 cholangitis, the rates of technical success, clinical success, and AEs did not significantly differ between the two groups. However, the median procedure time was significantly shorter in the EUS-BD group than in the BAE-ERCP group (32.5 [IQR, 28.8-52.5] minutes vs. 70 [IQR, 56.3-90.0] minutes, P<0.01). Conclusion : While both BAE-ERCP and EUS-BD can be performed safely and effectively in patients with AC and SAA, the procedure time is significantly shorter with EUS-BD than with BAE-ERCP.https://www.ijgii.org/journal/view.html?doi=10.18528/ijgii240070adverse effectsballoon enteroscopycholangiopancreatography, endoscopic retrogradegastric bypasshumans |
| spellingShingle | Takahiro Shishimoto Masahiro Itonaga Reiko Ashida Yasunobu Yamashita Yuki Kawaji Takashi Tamura Hiromu Morishita Akiya Nakahata Yuto Sugihara Tomokazu Ishihara Masayuki Kitano Emergent treatment using balloon-assisted ERCP versus EUS-guided drainage for acute cholangitis in patients with surgically altered anatomy International Journal of Gastrointestinal Intervention adverse effects balloon enteroscopy cholangiopancreatography, endoscopic retrograde gastric bypass humans |
| title | Emergent treatment using balloon-assisted ERCP versus EUS-guided drainage for acute cholangitis in patients with surgically altered anatomy |
| title_full | Emergent treatment using balloon-assisted ERCP versus EUS-guided drainage for acute cholangitis in patients with surgically altered anatomy |
| title_fullStr | Emergent treatment using balloon-assisted ERCP versus EUS-guided drainage for acute cholangitis in patients with surgically altered anatomy |
| title_full_unstemmed | Emergent treatment using balloon-assisted ERCP versus EUS-guided drainage for acute cholangitis in patients with surgically altered anatomy |
| title_short | Emergent treatment using balloon-assisted ERCP versus EUS-guided drainage for acute cholangitis in patients with surgically altered anatomy |
| title_sort | emergent treatment using balloon assisted ercp versus eus guided drainage for acute cholangitis in patients with surgically altered anatomy |
| topic | adverse effects balloon enteroscopy cholangiopancreatography, endoscopic retrograde gastric bypass humans |
| url | https://www.ijgii.org/journal/view.html?doi=10.18528/ijgii240070 |
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