ERCP using balloon-assisted endoscopes versus EUS-guided treatment for common bile duct stones in Roux-en-Y gastrectomy.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Sato Tatsuya, Nakai Yousuke, Kogure Hirofumi, Mitsuyama Toshiyuki, Shimatani Masaaki, Uemura Shinya, Iwashita Takuji, Tanisaka Yuki, Ryozawa Shomei, Tsuchiya Takayoshi, Itoi Takao, Kin Toshifumi, Katanuma Akio, Kashima Ken, Irisawa Atsushi, Kayashima Atsuto, Iwasaki Eisuke, Yoshida Akihiro, Takenaka Mamoru, Himei Hitomi, Kato Hironari, Masuda Atsuhiro, Shiomi Hideyuki, Kawakubo Kazumichi, Kuwatani Masaki, Otsuka Takeshi, Matsubara Saburo, Nishioka Nobu, Ogura Takeshi, Tamura Takaaki, Kitano Masayuki, Hayashi Nobuhiko, Yasuda Ichiro, Fujishiro Mitsuhiro
Аннотация
METHODS: Consecutive patients who had previous R-Y gastrectomy undergoing BE-ERCP or EUS-AG for CBD stones in 16 centers were retrospectively analyzed.
RESULTS: BE-ERCP and EUS-AG were performed in 588 and 59 patients, respectively. Baseline characteristics were similar, except for CBD diameter and angle. The technical success rate was 83.7% versus 83.1% (P = .956), complete stone removal rate was 78.1% versus 67.8% (P = .102), and early adverse event rate was 10.2% versus 18.6% (P = .076) in BE-ERCP and EUS-AG, respectively. The mean number of endoscopic sessions was smaller in BE-ERCP (1.5 ± .8 vs 1.9 ± 1.0 sessions, P = .01), whereas the median total treatment time was longer (90 vs 61.5 minutes, P = .001). Among patients with biliary access, the complete stone removal rate was significantly higher in BE-ERCP (93.3% vs 81.6%, P = .009). Negative predictive factors were CBD diameter ≥15 mm (odds ratio [OR], .41) and an angle of CBD <90 degrees (OR, .39) in BE-ERCP and a stone size ≥10 mm (OR, .07) and an angle of CBD <90 degrees (OR, .07) in EUS-AG. The 1-year recurrence rate was 8.3% in both groups.
CONCLUSIONS: Effectiveness and safety of BE-ERCP and EUS-AG were comparable in CBD stone removal for patients after R-Y gastrectomy, but complete stone removal after technical success was superior in BE-ERCP.