Ivano FH, Ponte BJ, Dubik TC, Ivano VK, Winkeler VLL, Kay AK. ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP): ANALYSIS OF THE EFFECTIVENESS AND SAFETY OF THE PROCEDURE IN THE PATIENT WITH ROUX-EN-Y GASTRIC BYPASS.
Arq Bras Cir Dig 2019;
32:e1432. [PMID:
31038557 PMCID:
PMC6488270 DOI:
10.1590/0102-672020190001e1432]
[Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 01/16/2019] [Indexed: 01/22/2023]
Abstract
Background:
Obesity can be treated with bariatric surgery; but, excessive weight loss
may lead to diseases of the bile duct such as cholelithiasis and
choledocholithiasis. Endoscopic retrograde cholangiopancreatography is a
diagnostic and therapeutic procedure for these conditions, and may be
hampered by the anatomical changes after surgery.
Aim:
Report the efficacy and the safety of videolaparoscopy-assisted endoscopic
retrograde cholangiopancreatography technique in patients after bariatric
surgery with Roux-en-Y gastric bypass.
Method:
Retrospective study performed between 2007 and 2017. Data collected were:
age, gender, surgical indication, length of hospital stay, etiological
diagnosis, rate of therapeutic success, intra and postoperative
complications.
Results:
Seven patients had choledocholithiasis confirmed by image exam, mainly in
women. The interval between gastric bypass and endoscopic procedure ranged
from 1 to 144 months. There were no intraoperative complications. The rate
of duodenal papillary cannulation was 100%. Regarding complications, the
majority of cases were related to gastrostomy, and rarely to endoscopic
procedure. There were two postoperative complications, a case of
chest-abdominal pain refractory to high doses of morphine on the same day of
the procedure, and a laboratory diagnosis of acute pancreatitis after the
procedure in an asymptomatic patient. The maximum hospital stay was four
days.
Conclusion:
The experience with endoscopic retrograde cholangiopancreatography through
laparoscopic gastrostomy is a safe and effective procedure, since most
complications are related to the it and did not altered the sequence to
perform the conventional cholangiopancreatography.
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