Evidence map›Paper›PMID 30302653›Full record

ArticleObesity surgery2019

Endoscopic Ultrasound-Directed Transgastric ERCP (EDGE): a Single-Center US Experience with Follow-up Data on Fistula Closure.

Theodore W James, Todd Huntley Baron

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Obesity surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 8 pooled it
5.7field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 8 syntheses or guidelines pooled it, 75 citations in OpenAlex.

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  6. Biliopancreatic Endoscopy in Altered Anatomy.Medicina (Kaunas, Lithuania) · 2021
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  10. [Laparoscopy-assisted ERCP after gastric bypass surgery].Chirurgie (Heidelberg, Germany) · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 1 institution in 1 country.

Theodore W JamesDivision of Gastroenterology and Hepatology, University of North Carolina, 130 Mason Farm Road, CB 7080, Chapel Hill, NC, 27599, USA.
Todd Huntley BaronDivision of Gastroenterology and Hepatology, University of North Carolina, 130 Mason Farm Road, CB 7080, Chapel Hill, NC, 27599, USA. todd_baron@med.unc.edu.
University of North Carolina at Chapel Hill · US

Funding

DIGESTIVE DISEASES EPIDEMIOLOGY TRAINING PROGRAMT32DK007634 · NIDDK · UNIV OF NORTH CAROLINA CHAPEL HILL · PI ROBERT S. SANDLER · 1990 to 2026
$7.4M
NIDDK NIH HHS T32 DK007634
6 · The paper itself

Abstract

backgroundEndoscopic ultrasound-directed transgastric ERCP (EDGE) by creating an anastomosis from the gastric pouch or jejunum to the excluded stomach allows performance of ERCP in Roux-en-Y gastric bypass (RYGB) anatomy. Concern for persistent fistula following stent removal and sparse data limit adoption.

methodsRetrospective review of consecutive patients undergoing EDGE over a 2-year period.

resultsNineteen RYGB patients underwent EDGE; three had previously failed ERCP by the device-assisted method. Indications for ERCP were choledocholithiasis (8), recurrent acute pancreatitis (6), benign post-surgical stricture (3), elevated bilirubin, and papillary stenosis (1 each). EDGE was technically successful in all 19 patients with jejunogastric anastomosis in 11 patients and gastrogastric in 8 using a 15-mm lumen-apposing metal stent. Stent malposition occurred in six and was managed by rescue maneuvers. ERCP was performed in the same session in four patients; the remainder were delayed after a mean of 48 days. Diagnostic endoscopic ultrasound (EUS) was performed in four patients. No severe adverse events occurred; clinical success was 100%. Stents were removed after a mean dwell time of 182 days. Argon plasma coagulation (APC) was used to promote fistula closure in 12 patients. Upper GI series to assess fistula closure was obtained in 11 patients after a mean of 182 days following stent removal. One persistent fistula was identified and closed endoscopically.

conclusionsEDGE is an effective modality for performing ERCP in patients with RYGB anatomy and can be performed via gastrogastric or jejunogastric approaches. Persistent fistula is uncommon and can be managed endoscopically. APC may promote fistula closure.

Indexed as

Cholangiopancreatography, Endoscopic RetrogradeGastric BypassCholedocholithiasisHumansObesityPancreatitisReoperationRetrospective StudiesUltrasonography, InterventionalEDGEEndoscopic ultrasoundERCPEUS-GG-ERCPGastric bypassRoux-en-Y

Identifiers

PMID30302653
PMCPMC6550479
OpenAlexW2896290085

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.