Evidence map›Paper›PMID 33543349›Full record

ArticleSurgical endoscopy2022

Laparoscopic-assisted ERCP following RYGB: a 12-year assessment of outcomes and learning curve at a high-volume pancreatobiliary center.

Samer AlMasri, Mazen S Zenati, Georgios I Papachristou, Adam Slivka, Michael Sanders, Jennifer Chennat, Mordechai Rabinowitz, Asif Khalid, Andres Gelrud, John Nasr and 10 more

Erratum issuedAbstract read
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In one paragraph

Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
0.9field-weighted citation impact, top 26% 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

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. [Laparoscopy-assisted ERCP after gastric bypass surgery].Chirurgie (Heidelberg, Germany) · 2026
    Article
  5. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors at 7 institutions in 1 country.

Samer AlMasriDepartment of Surgery, University of Pittsburgh Medical Center, 5150 Center Ave., Suite 421, Pittsburgh, PA, 15232, USA.
Mazen S ZenatiDepartment of Surgery and Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
Georgios I PapachristouDepartment of Surgery, The Ohio State University, Wexner Medical Center, Columbus, OH, USA.
Adam SlivkaDepartment of Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Michael SandersDepartment of Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Jennifer ChennatDepartment of Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Mordechai RabinowitzDepartment of Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Asif KhalidDepartment of Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Andres GelrudDepartment of Internal Medicine, Miami Cancer Institute, Gastro Health, Miami, FL, USA.
John NasrDepartment of Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Savreet SarkariaDepartment of Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Rohit DasDepartment of Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Kenneth K LeeDepartment of Surgery, University of Pittsburgh Medical Center, 5150 Center Ave., Suite 421, Pittsburgh, PA, 15232, USA.
Wolfgang SchrautDepartment of Surgery, University of Pittsburgh Medical Center, 5150 Center Ave., Suite 421, Pittsburgh, PA, 15232, USA.
Steve J HughesDepartment of Surgery, University of Florida, Gainesville, FL, USA.
A James MoserDepartment of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Alessandro PanicciaDepartment of Surgery, University of Pittsburgh Medical Center, 5150 Center Ave., Suite 421, Pittsburgh, PA, 15232, USA.
Melissa E HoggDepartment of Surgery, NorthShore Hospital System, Chicago, IL, USA.
Herbert J ZehDepartment of Surgery, University of Texas Southwestern, Dallas, TX, USA.
Amer H ZureikatDepartment of Surgery, University of Pittsburgh Medical Center, 5150 Center Ave., Suite 421, Pittsburgh, PA, 15232, USA. zureikatah@upmc.edu.
University of Pittsburgh · USUniversity of Pittsburgh Medical Center · USBeth Israel Deaconess Medical Center · USNorthShore University HealthSystem · USThe Ohio State University Wexner Medical Center · USThe University of Texas Southwestern Medical Center · USUniversity of Florida · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTreatment of pancreaticobiliary pathology following Roux-en-Y gastric bypass (RYGB) poses significant technical challenges. Laparoscopic-assisted endoscopic retrograde cholangiopancreatography (LA-ERCP) can overcome those anatomical hurdles, allowing access to the papilla. Our aims were to analyze our 12-year institutional outcomes and determine the learning curve for LA-ERCP.

methodsA retrospective review of cases between 2007 and 2019 at a high-volume pancreatobiliary unit was performed. Logistic regression was used to identify predictors of specific outcomes. To identify the learning curve, CUSUM analyses and innovative methods for standardizing the surgeon's timelines were performed.

results131 patients underwent LA-ERCP (median age 60, 81% females) by 17 surgeons and 10 gastroenterologists. Cannulation of the papilla was achieved in all cases. Indications were choledocholithiasis (78%), Sphincter of Oddi dysfunction/Papillary stenosis (18%), management of bile leak (2%) and stenting/biopsy of malignant strictures (2%). Median total, surgical and ERCP times were 180, 128 and 48 min, respectively, and 47% underwent concomitant cholecystectomy. Surgical site infection developed in 9.2% and post-ERCP pancreatitis in 3.8%. Logistic regression revealed multiple abdominal operations and magnitude of BMI decrease (between RYGB and LA-ERCP) to be predictive of conversion to open approach. CUSUM analysis of operative time demonstrated a learning curve at case 27 for the surgical team and case 9 for the gastroenterology team. On binary cut analysis, 3-5 cases per surgeon were needed to optimize operative metrics.

conclusionLA-ERCP is associated with high success rates and low adverse events. We identify outcome benchmarks and a learning curve for new adopters of this increasingly performed procedure.

Indexed as

CholedocholithiasisGastric BypassLaparoscopyCholangiopancreatography, Endoscopic RetrogradeFemaleHumansLearning CurveMaleMiddle AgedRetrospective StudiesERCPGastric bypassLaparoscopyLearning curve

Identifiers

PMID33543349
OpenAlexW3127422809

What OpenQuestion holds

Textmetadata
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.