Procedural Outcomes of Laparoscopic-Assisted Endoscopic Retrograde Cholangiopancreatography in Patients with Previous Ro
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ORIGINAL CONTRIBUTIONS
Procedural Outcomes of Laparoscopic-Assisted Endoscopic Retrograde Cholangiopancreatography in Patients with Previous Roux-en-Y Gastric Bypass Surgery: a Systematic Review and Meta-analysis Shahab Hajibandeh 1
&
Shahin Hajibandeh 2 & Munir Tarazi 3 & Moustafa Mansour 4 & Thomas Satyadas 3
Received: 10 March 2020 / Revised: 26 August 2020 / Accepted: 31 August 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To investigate the procedural outcomes of laparoscopic-assisted endoscopic retrograde cholangiopancreatography (ERCP) in patients with previous Roux-en-Y gastric bypass (RYGB) surgery. Materials and Methods We performed a systematic review in accordance with PRISMA statement standards to identify all studies reporting procedural outcomes of laparoscopic-assisted ERCP in patients with previous RYGB. The ROBINS-I tool was used to assess the risk of bias of the included studies. Fixed-effect and random-effects models were applied to calculate pooled outcome data. Results A total of 17 case series, enrolling 256 patients, were included. The mean age of included patients was 49. The mean procedure time was 137 min (95% CI 102–172). In terms of procedural success rates, the overall technical success was 95.3% (95% CI 92.5–97.5, I2 = 0%), papillary access success was 95.3% (95% CI 92.5–97.5, I2 = 0%), cannulation success was 95.3% (95% CI 92.5–97.5, I2 = 0%), sphincterotomy success was 96.1% (95% CI 93.5–98.1, I2 = 0%), and stone removal success was 95.9% (95% CI 92.4–98.4, I2 = 0%). Conversion to open was required in 4.7% (95% CI 2.5–7.6, I2 = 0%). In terms of complications, pancreatitis occurred in 4.7% (95% CI 2.3–8, I2 = 17%), cholangitis in 1.7% (95% CI 0.5–3.6, I2 = 0%), and perforation in 3.7% (95% CI 1.8–6.3, I2 = 0%). The length of hospital stay was 3 days (95% CI 2–4). Conclusions Laparoscopic-assisted ERCP seems to be feasible, effective, and a safe method to access the biliary tract in patients with previous RYGB as indicated by high technical success rates and low complication rates. There is a need for comparative evidence regarding outcomes of laparoscopic ERCP in comparison with alternative treatment options. Keywords Cholangiopancreatographies . Endoscopic retrograde . Gastric bypass . Roux-en-y
Introduction Shahab Hajibandeh and Shahin Hajibandeh contributed equally to this work. * Shahab Hajibandeh [email protected] 1
Department of General Surgery, Glan Clwyd Hospital, Rhyl, Denbighshire, UK
2
Department of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
3
Department of Hepatobiliary and Pancreatic Surgery, Manchester Royal Infirmary Hospital, Manchester, UK
4
Department of Upper Gastrointestinal Surgery, North Manchester General Hospital, Manchester, UK
Bariatric surgery is one of the fastest growing operative procedures performed worldwide. It is estimated that more than 340,000 bariatric operations were performed in 2011 [1]. The Roux-en-Y gastric bypass (RYGB) is one of the m
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