Effectiveness of double-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (DBE-ERCP): A multicenter real-world study

Background and aims: To investigate the effectiveness of double-balloon enteroscope-assisted retrograde cholangiopancreatography (DBE-ERCP) in patients with gastrointestinal surgically altered anatomy (SAA).Methods: From May 2013 to October 2021, all consecutive patients undergoing DBE-ERCP in three gas-troenterological referral centers in Northern Italy were enrolled in the study. Patients were assessed re-garding their medical history, previous surgery, time from previous surgery to the DBE-ERCP procedure, and the success or failure of DBE-ERCP.Results: Fifty-three patients (60% men, median age 65 (23-89) years) undergoing 67 DBE-ERCP proce-dures (1-3 DBE-ERCP per patient) were enrolled. Reasons for SAA included orthotopic liver transplanta-tion (23%), ulcers (15%), malignancies (43%), difficult cholecystectomy (17%), and other causes (2%). Types of surgery included Roux-en-Y biliodigestive anastomosis (45%), Roux-en-Y gastrectomy (32%), pancreati-coduodenectomy (17%), and Billroth II gastrectomy (6%). The overall DBE-ERCP success rate was 86%. The type of surgery, indications, and the length of time between previous surgery and DBE-ERCP were not statistically associated with DBE-ERCP success. The DBE-ERCP success rate increased from 2018 to 2021.Conclusions: DBE-ERCP is a successful procedure in challenging patients with SAA. The improvement in results over time indicates the necessity of adequate training and of centralizing patients in referral centers.(c) 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Automated summary

The effectiveness of double-balloon enteroscope-assisted retrograde cholangiopancreatography (DBE-ERCP) in patients with surgically altered anatomy (SAA) was investigated. The study found that DBE-ERCP was successful in these challenging patients, and there has been improvement in the results over the years, suggesting the need for adequate training and centralization of patients in specialized centers.