ArticleSurgical endoscopy2021
Endoscopic and percutaneous biliary interventions in patients with altered upper gastrointestinal anatomy-the Munich Multicenter Experience.
Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 16 citations in OpenAlex.
- Current Evidence on Endoscopic Biliary Drainage in the Era of Surgically Altered Anatomy: A Narrative Review.Medicina (Kaunas, Lithuania) · 2026Review
- Biliary drainage in patients with altered anatomy: Literature review of different endoscopic approaches.World journal of gastroenterology · 2026Review
- Motorized spiral enteroscopy assisted endoscopic retrograde cholangiography in patients with Roux-en-Y-anatomy.World journal of gastrointestinal endoscopy · 2025Article
- Percutaneous Cholangioscopy-Guided Crossing of Biliary-Enteric Anastomotic Strictures After Failure of Endoscopy and Conventional Percutaneous Techniques.Cardiovascular and interventional radiology · 2025Article
- Endoscopic approach for biliopancreatic disease after pancreaticoduodenectomy: a 10-year single-center experience.Surgical endoscopy · 2024Article
- Italian Survey on Endoscopic Biliary Drainage Approach in Patients with Surgically Altered Anatomy.Medicina (Kaunas, Lithuania) · 2024Article
- Endoscopic Biliary Drainage in Surgically Altered Anatomy.Diagnostics (Basel, Switzerland) · 2023Review
- Side-Viewing Duodenoscope versus Forward-Viewing Gastroscope for Endoscopic Retrograde Cholangiopancreatography in Billroth II Gastrectomy Patients.GE Portuguese journal of gastroenterology · 2023Article
- [Endoscopic retrograde cholangiopancreatography in patients after bilioenteric anstomosis].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2022Article
- Comparison between Enteroscopy-, Laparoscopy- and Endoscopic Ultrasound-Assisted Endoscopic Retrograde Cholangio-Pancreatography in Patients with Surgically Altered Anatomy: A Systematic Review and Meta-Analysis.Life (Basel, Switzerland) · 2022Review
- Endoscopic Accessibility of the Biliary System in the Postoperative Situs.Visceral medicine · 2022Review
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Authors and funding
12 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn patients with altered upper gastrointestinal anatomy, conventional endoscopic retrograde cholangiography is often not possible and different techniques, like enteroscopy-assisted or percutaneous approaches are required. Aim of this study was to analyze success and complication rates of these techniques in a large collective of patients in the daily clinical practice in a pre-endosonographic biliary drainage era. PATIENTS AND
methodsPatients with altered upper gastrointestinal anatomy with biliary interventions between March 1st, 2006, and June 30th, 2014 in four tertiary endoscopic centers in Munich, Germany were retrospectively analyzed.
resultsAt least one endoscopic-assisted biliary intervention was successful in 234/411 patients (56.9%)-in 192 patients in the first, in 34 patients in the second and in 8 patients in the third attempt. Success rates for Billroth-II/Whipple-/Roux-en-Y reconstruction were 70.5%/56.7%/49.5%. Complication rates for these reconstructions were 9.3%/6.5%/6.3%, the overall complication rate was 7.1%. Success rates were highest in patients with Billroth-II reconstruction where use of a duodenoscope was possible, complication rates were also highest in this scenario. Success rates were lowest in longer-limb anatomy like Roux-en-Y reconstruction. Percutaneous biliary drainages (PTBD) were inserted 268 times with substantially higher success (90.7%) as well as complication rates (11.6%) compared to the endoscopic approach. Compared to patients treated endoscopically, patients with PTBD had a lower performance status, more severe cholestasis and a significant higher rate of malignant underlying disease.
conclusionIn patients with altered upper gastrointestinal anatomy, success rates of endoscopic-assisted biliary interventions are lower compared to PTBD. Still, due to the beneficial complication rates of the endoscopic approach, this technique should be preferred whenever possible and in selected patients who still need to be defined in detail, repeated endoscopic attempts are useful to help achieve the desired result.
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