Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy.
Division of Gastroenterology, Lenox Hill Hospital, New York, New York, USA.
Endoscopy. 2021 Sep;53(9):927-931. doi: 10.1055/a-1311-9779. Epub 2021 Jan 12.
Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy (SAA) is technically challenging and associated with a significant number of failures. We examined the feasibility and efficacy of a novel technique for the management of bile duct stones (BDSs), called underwater cap-assisted ERCP (u-ERCP). METHODS : Between June 2019 and February 2020 all patients with SAA with jaundice or cholangitis secondary to BDSs who underwent u-ERCP were enrolled. The u-ERCP technique combines the underwater advancement of a pediatric colonoscope with a transparent cap fitted on the tip of the endoscope. We evaluated the technical success, clinical success, and adverse events associated with u-ERCP. RESULTS : We describe the technique itself and our initial experience in six patients. A complete and successful procedure was carried out in all patients, with the occurrence of no adverse events. None of the patients needed additional treatments for recurrence of symptoms during the follow-up period. CONCLUSIONS : u-ERCP can be considered as a promising alternative for successful endoscopic management of biliary disease in patients with SAA.
内镜逆行胰胆管造影（ERCP）在解剖结构改变（SAA）的患者中具有一定的技术挑战性，并且与大量失败相关。我们研究了一种称为水下帽辅助 ERCP（u-ERCP）的新型胆管结石（BDS）治疗方法的可行性和疗效。方法：2019 年 6 月至 2020 年 2 月，所有因 BDS 引起黄疸或胆管炎的 SAA 患者均接受 u-ERCP 治疗。u-ERCP 技术结合了水下推进儿科结肠镜和适合内窥镜尖端的透明帽。我们评估了 u-ERCP 的技术成功率、临床成功率和不良事件。结果：我们描述了该技术本身和我们在 6 名患者中的初步经验。所有患者均成功完成了完整的手术，且未发生不良事件。在随访期间，没有患者因症状复发而需要额外的治疗。结论：u-ERCP 可被视为治疗 SAA 患者胆道疾病的一种有前途的内镜治疗方法。
