Outcomes of biliopancreatic EUS in patients with surgically altered upper gastrointestinal anatomy: a multicenter study
Background and study aims Little is known about outcomes of biliopancreatic endosonography (EUS) in patients with surgically altered upper gastrointestinal (gastrointestinal) anatomy. We aimed to assess the rate of procedural success and EUS-related adverse events (AEs), according to post-surgical a...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Georg Thieme Verlag KG
2020-06-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1161-8713 |
| _version_ | 1828348198877396992 |
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| author | Lorenzo Brozzi Maria Chiara Petrone Jan-Werner Poley Silvia Carrara Luca Barresi Carlo Fabbri Mihai Rimbas Claudio De Angelis Paolo Giorgio Arcidiacono Marianna Signoretti Laura Lamonaca Ilenia Barbuscio Cecilia Binda Andrada Gheorghe Stefano Rizza Armando Gabbrielli Stefano Francesco Crinò |
| author_facet | Lorenzo Brozzi Maria Chiara Petrone Jan-Werner Poley Silvia Carrara Luca Barresi Carlo Fabbri Mihai Rimbas Claudio De Angelis Paolo Giorgio Arcidiacono Marianna Signoretti Laura Lamonaca Ilenia Barbuscio Cecilia Binda Andrada Gheorghe Stefano Rizza Armando Gabbrielli Stefano Francesco Crinò |
| author_sort | Lorenzo Brozzi |
| collection | DOAJ |
| description | Background and study aims Little is known about outcomes of biliopancreatic endosonography (EUS) in patients with surgically altered upper gastrointestinal (gastrointestinal) anatomy. We aimed to assess the rate of procedural success and EUS-related adverse events (AEs), according to post-surgical anatomies.
Patients and methods Retrospective study including patients with post-surgical altered upper gastrointestinal anatomy who underwent EUS for evaluation of the biliopancreatic region between January 2008 and June 2018 at eight European centers.
Results Of 242 patients (162 males, mean age 66.4 ± 12.5), 86 had (35.5 %) Billroth II, 77 (31.8 %) pancreaticoduodenectomy, 23 (9.5 %) Billroth I, 19 (7.9 %) distal esophagectomy, 15 (6.2 %) total gastrectomy, 14 (5.8 %) sleeve gastrectomy, and eight (3.3 %) Roux-en-Y. Sleeve gastrectomy, Billroth I, and pancreaticoduodenectomy were associated with high rates of success (100 %, 95.7 %, and 92.2 %, respectively). Visualization of the head of the pancreas was significantly impacted by total gastrectomy, Billroth II, and Roux-en-Y (success rates 6.7 %, 53.7 %, and 57.1 %, respectively). Examination of the pancreatic body and tail was impaired in esophagectomy and total gastrectomy (82.4 % and 71.4 %, respectively). Technical success and diagnostic accuracy of EUS-guided tissue acquisition (EUS-TA) was 78.2 % and 71.3 % (95 % CI, 60.6–80.5), respectively. Four (1.6 %) AEs were observed: one mucosal tearing in a Billroth II patient, one cardiac arrest in a distal esophagectomy patient, one bleed after EUS-TA in a Billroth I patient, and one acute pancreatitis after EUS-TA in a sleeve gastrectomy patient.
Conclusions The yield of bilio-pancreatic EUS is dependent on lesion location and surgery type. Before considering EUS in these patients, one must carefully consider whether the lesion may be approachable by EUS. |
| first_indexed | 2024-04-14T00:51:14Z |
| format | Article |
| id | doaj.art-e442e2c9c19f45f7adad6cd3a8d9df6b |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-04-14T00:51:14Z |
| publishDate | 2020-06-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-e442e2c9c19f45f7adad6cd3a8d9df6b2022-12-22T02:21:48ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362020-06-010807E869E87610.1055/a-1161-8713Outcomes of biliopancreatic EUS in patients with surgically altered upper gastrointestinal anatomy: a multicenter studyLorenzo Brozzi0Maria Chiara Petrone1Jan-Werner Poley2Silvia Carrara3Luca Barresi4Carlo Fabbri5Mihai Rimbas6Claudio De Angelis7Paolo Giorgio Arcidiacono8Marianna Signoretti9Laura Lamonaca10Ilenia Barbuscio11Cecilia Binda12Andrada Gheorghe13Stefano Rizza14Armando Gabbrielli15Stefano Francesco Crinò16Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, G.B. Rossi University Hospital, Verona, ItalyPancreatoBiliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS, Milan, ItalyDepartment of Gastroenterology and Hepatology, Erasmus MC, University Medical Centre, Rotterdam, the NetherlandsHumanitas Clinical and Research Center- IRCCS- Digestive Endoscopy Unit, Division of Gastroenterology, Rozzano (Milan), ItalyEndoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Highly Specialized Therapies), Palermo, ItalyUnit of Gastroenterology and Digestive Endoscopy, Forli-Cesena Hospital, AUSL Romagna, Forli-Cesena, ItalyGastroenterology Department, Colentina Clinical Hospital, Carol Davila University of Medicine, Bucharest, RomaniaGastroenterology and Digestive Endoscopy Unit, Città della Salute e della Scienza di Torino, Turin, ItalyPancreatoBiliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS, Milan, ItalyDepartment of Gastroenterology and Hepatology, Erasmus MC, University Medical Centre, Rotterdam, the NetherlandsHumanitas Clinical and Research Center- IRCCS- Digestive Endoscopy Unit, Division of Gastroenterology, Rozzano (Milan), ItalyEndoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Highly Specialized Therapies), Palermo, ItalyUnit of Gastroenterology and Digestive Endoscopy, Forli-Cesena Hospital, AUSL Romagna, Forli-Cesena, ItalyGastroenterology Department, Colentina Clinical Hospital, Carol Davila University of Medicine, Bucharest, RomaniaGastroenterology and Digestive Endoscopy Unit, Città della Salute e della Scienza di Torino, Turin, ItalyGastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, G.B. Rossi University Hospital, Verona, ItalyGastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, G.B. Rossi University Hospital, Verona, ItalyBackground and study aims Little is known about outcomes of biliopancreatic endosonography (EUS) in patients with surgically altered upper gastrointestinal (gastrointestinal) anatomy. We aimed to assess the rate of procedural success and EUS-related adverse events (AEs), according to post-surgical anatomies. Patients and methods Retrospective study including patients with post-surgical altered upper gastrointestinal anatomy who underwent EUS for evaluation of the biliopancreatic region between January 2008 and June 2018 at eight European centers. Results Of 242 patients (162 males, mean age 66.4 ± 12.5), 86 had (35.5 %) Billroth II, 77 (31.8 %) pancreaticoduodenectomy, 23 (9.5 %) Billroth I, 19 (7.9 %) distal esophagectomy, 15 (6.2 %) total gastrectomy, 14 (5.8 %) sleeve gastrectomy, and eight (3.3 %) Roux-en-Y. Sleeve gastrectomy, Billroth I, and pancreaticoduodenectomy were associated with high rates of success (100 %, 95.7 %, and 92.2 %, respectively). Visualization of the head of the pancreas was significantly impacted by total gastrectomy, Billroth II, and Roux-en-Y (success rates 6.7 %, 53.7 %, and 57.1 %, respectively). Examination of the pancreatic body and tail was impaired in esophagectomy and total gastrectomy (82.4 % and 71.4 %, respectively). Technical success and diagnostic accuracy of EUS-guided tissue acquisition (EUS-TA) was 78.2 % and 71.3 % (95 % CI, 60.6–80.5), respectively. Four (1.6 %) AEs were observed: one mucosal tearing in a Billroth II patient, one cardiac arrest in a distal esophagectomy patient, one bleed after EUS-TA in a Billroth I patient, and one acute pancreatitis after EUS-TA in a sleeve gastrectomy patient. Conclusions The yield of bilio-pancreatic EUS is dependent on lesion location and surgery type. Before considering EUS in these patients, one must carefully consider whether the lesion may be approachable by EUS.http://www.thieme-connect.de/DOI/DOI?10.1055/a-1161-8713 |
| spellingShingle | Lorenzo Brozzi Maria Chiara Petrone Jan-Werner Poley Silvia Carrara Luca Barresi Carlo Fabbri Mihai Rimbas Claudio De Angelis Paolo Giorgio Arcidiacono Marianna Signoretti Laura Lamonaca Ilenia Barbuscio Cecilia Binda Andrada Gheorghe Stefano Rizza Armando Gabbrielli Stefano Francesco Crinò Outcomes of biliopancreatic EUS in patients with surgically altered upper gastrointestinal anatomy: a multicenter study Endoscopy International Open |
| title | Outcomes of biliopancreatic EUS in patients with surgically altered upper gastrointestinal anatomy: a multicenter study |
| title_full | Outcomes of biliopancreatic EUS in patients with surgically altered upper gastrointestinal anatomy: a multicenter study |
| title_fullStr | Outcomes of biliopancreatic EUS in patients with surgically altered upper gastrointestinal anatomy: a multicenter study |
| title_full_unstemmed | Outcomes of biliopancreatic EUS in patients with surgically altered upper gastrointestinal anatomy: a multicenter study |
| title_short | Outcomes of biliopancreatic EUS in patients with surgically altered upper gastrointestinal anatomy: a multicenter study |
| title_sort | outcomes of biliopancreatic eus in patients with surgically altered upper gastrointestinal anatomy a multicenter study |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1161-8713 |
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