Effectiveness of Peroral Direct Cholangioscopy Using an Ultraslim Endoscope for the Treatment of Hepatolithiasis in Patients with Hepaticojejunostomy (with Video)

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2015 Jul 1

PMID 26123333

Citations 6

Authors

Kazuyuki Matsumoto

Koichiro Tsutsumi

Hironari Kato

Yutaka Akimoto

Daisuke Uchida

Takeshi Tomoda

Naoki Yamamoto

Yasuhiro Noma

Shigeru Horiguchi

Hiroyuki Okada

Kazuhide Yamamoto

Affiliations

Soon will be listed here.

Abstract

Background: Hepatolithiasis is a postoperative complication of hepaticojejunostomy (HJ) performed for various pancreatobiliary diseases. Hepatolithiasis can cause repeated cholangitis. Complete stone removal and bile stasis elimination are therefore necessary. Here, we evaluated the effectiveness of peroral direct cholangioscopy (PDCS) using an ultraslim endoscope for treating hepatolithiasis in HJ patients.

Methods: We studied 14 patients with hepatolithiasis who underwent bowel reconstruction with HJ between April 2012 and May 2014. Diagnostic and therapeutic endoscopic retrograde cholangiography using a short double-balloon enteroscope (DBE) was initially performed. Following stone removal, the DBE was exchanged for an ultraslim endoscope through the balloon overtube for PDCS.

Results: The success rate of PDCS procedure was 85.7% (12/14). In 5 of 12 (41.7%) patients with successful PDCS, the residual stones were detected and removed completely using a 5-Fr basket catheter and suction after normal saline irrigation. In the remaining 7 (58.3%) patients, no residual stone was detected. The median procedure time was 14 min (range 8-36) with no serious postoperative complications. The median follow-up time after PDCS was 21 months (range 5-26), and only 1 patient (8.3%) had IHBD stone recurrence with an anastomotic stricture.

Conclusions: PDCS using an ultraslim endoscope appears to be useful for detecting and removing residual stones following hepatolithiasis treatment using a DBE. The combined use of a DBE and PDCS may reduce the risk of hepatolithiasis recurrence in HJ patients.

Citing Articles

Balloon endoscopy-assisted endoscopic retrograde cholangiopancreatography for hepatolithiasis in patients with hepaticojejunostomy.

Hakuta R, Sato T, Nakai Y, Kogure H, Nishio H, Kurihara K Surg Endosc. 2024; 38(5):2423-2432.

PMID: 38453748 PMC: 11078785. DOI: 10.1007/s00464-024-10738-6.

Transjejunal Laparoscopic Assisted ERCP in a Patient with Roux-en-Y Hepaticojejunostomy.

Baca-Arzaga A, Navarro-Chavez H, Galindo J, Santibanez-Juarez J, Cardosa-Gonzalez C, Flores-Villalba E Medicina (Kaunas). 2019; 55(8).

PMID: 31416274 PMC: 6723649. DOI: 10.3390/medicina55080483.

Current status of endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy.

Krutsri C, Kida M, Yamauchi H, Iwai T, Imaizumi H, Koizumi W World J Gastroenterol. 2019; 25(26):3313-3333.

PMID: 31341358 PMC: 6639547. DOI: 10.3748/wjg.v25.i26.3313.

Treatment Using the SpyGlass Digital System in a Patient with Hepatolithiasis after a Whipple Procedure.

Harima H, Hamabe K, Hisano F, Matsuzaki Y, Itoh T, Sanuki K Clin Endosc. 2018; 51(6):596-599.

PMID: 29788693 PMC: 6283764. DOI: 10.5946/ce.2018.057.

Therapeutic peroral direct cholangioscopy using a single balloon enteroscope in patients with Roux-en-Y anastomosis (with videos).

Yamauchi H, Kida M, Okuwaki K, Miyazawa S, Matsumoto T, Uehara K Surg Endosc. 2017; 32(1):498-506.

PMID: 28733743 DOI: 10.1007/s00464-017-5742-3.

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