Factors affecting complete stone extraction in the initial procedure in short type single-balloon enteroscopy-assisted endoscopic retrograde cholangiography for patients with Roux-en-Y gastrectomy

Abstract

Objectives

This study aimed to evaluate the efficacy and safety of stone extraction in patients who underwent Roux-en-Y gastrectomy using short-type single-balloon enteroscopy (SBE) and to clarify the factors affecting complete stone extraction in the initial procedure.

Methods

The data of patients with Roux-en-Y gastrectomy who underwent endoscopic stone extraction using short SBE between September 2011 and January 2022 was analyzed.

Results

Overall, 85 patients were scheduled to undergo stone extraction. 77 patients were intended stone extraction after successful biliary cannulation. The complete stone extraction success in the initial procedure, overall complete stone extraction success including repeated procedures, and adverse event rates were 68.2% (95% confidence interval [CI], 57.2%–77.9%), 87.1% (95% CI, 78.0%–93.4%), and 8.2% (95% CI, 3.4%–16.2%), respectively. Multiple logistic regression analysis indicated that bile duct diameter affected the success of complete stone extraction after successful biliary cannulation in the initial procedure (odds ratio 0.53, 95% CI, 0.30–0.94, p = .03).

Conclusions

Stone extraction in patients with Roux-en-Y gastrectomy using short SBE was effective. Patients with a large diameter bile duct required several sessions for complete stone extraction, suggesting that more dedicated devices are warranted for patients with surgically altered anatomy.

Keywords:

• Single-balloon enteroscopy
• balloon enteroscopy
• endoscopic retrograde cholangiopancreatography
• stone extraction
• Roux-en-Y anastomosis

Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

Specific author contributions

The paper was authored Yuki Tanisaka, who designed and drafted the article. Masafumi Mizuide, Akashi Fujita, Ryuhei Jinush, Tomoya Ogawa, Hiromune Katsuda, Yoichi Saito, Kazuya Miyaguchi, Rie Terada, Tomoaki Tashima, Yumi Mashimo, and Shomei Ryozawa provided critical revision of the article for important intellectual content. Ryuhei Jinushi interpreted statistical analysis. Yuki Tanisaka finally approved the article for submission. The final version of the manuscript was approved by all authors.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets used and analyzed in the current study are available from the corresponding author on reasonable request.