Evidence map›Paper›PMID 40900918›Full record

ArticleJournal of the Canadian Association of Gastroenterology2025

Factors affecting technical success of endoscopic retrograde cholangiopancreatographic outcomes in patients with surgically altered foregut anatomy: a retrospective study.

Michael A Scaffidi, Kareem Khalaf, Katarzyna M Pawlak, Deiya Chopra, Daniel Tham, Caleb Na, Ahmed H Mokhtar, Sharan B Malipatil, Yusuke Fujiyoshi, Nikko Gimpaya and 9 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the Canadian Association of Gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

19 authors.

Michael A ScaffidiDivision of Gastroenterology and Hepatology, University of Toronto, Toronto, ON M5S 1A1, Canada.ORCID https://orcid.org/0000-0003-2068-6655
Kareem KhalafDivision of Gastroenterology and Hepatology, University of Toronto, Toronto, ON M5S 1A1, Canada.ORCID https://orcid.org/0000-0002-5534-7533
Katarzyna M PawlakDivision of Gastroenterology and Hepatology, University of Toronto, Toronto, ON M5S 1A1, Canada.
Deiya ChopraDivision of Gastroenterology and Hepatology, University of Toronto, Toronto, ON M5S 1A1, Canada.
Daniel ThamDivision of Gastroenterology and Hepatology, University of Toronto, Toronto, ON M5S 1A1, Canada.
Caleb NaDivision of Gastroenterology and Hepatology, University of Toronto, Toronto, ON M5S 1A1, Canada.
Ahmed H MokhtarDivision of Gastroenterology and Hepatology, University of Toronto, Toronto, ON M5S 1A1, Canada.
Sharan B MalipatilDivision of Gastroenterology and Hepatology, University of Toronto, Toronto, ON M5S 1A1, Canada.
Yusuke FujiyoshiDivision of Gastroenterology and Hepatology, University of Toronto, Toronto, ON M5S 1A1, Canada.ORCID https://orcid.org/0000-0002-5893-6552
Nikko GimpayaDivision of Gastroenterology and Hepatology, University of Toronto, Toronto, ON M5S 1A1, Canada.
Reza GholamiDivision of Gastroenterology and Hepatology, University of Toronto, Toronto, ON M5S 1A1, Canada.
Brian P H ChanDivision of Gastroenterology, Department of Medicine, Scarborough Health Network, University of Toronto, Toronto, ON M1E 4B9, Canada.
Elaine T YeungDivision of Gastroenterology, Department of Medicine, Scarborough Health Network, University of Toronto, Toronto, ON M1E 4B9, Canada.
Nauzer ForbesDivision of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.ORCID https://orcid.org/0000-0002-6966-3908
Daniel J LowDivision of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON M5B 1W8, Canada.ORCID https://orcid.org/0000-0003-2867-9572
Natalia C CaloDivision of Gastroenterology and Hepatology, University of Toronto, Toronto, ON M5S 1A1, Canada.
Jeffrey D MoskoDivision of Gastroenterology and Hepatology, University of Toronto, Toronto, ON M5S 1A1, Canada.
Gary R MayDivision of Gastroenterology and Hepatology, University of Toronto, Toronto, ON M5S 1A1, Canada.
Samir C GroverDivision of Gastroenterology and Hepatology, University of Toronto, Toronto, ON M5S 1A1, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Patients with surgically altered gastrointestinal anatomy undergoing endoscopic retrograde cholangiopancreatography (ERCP) pose challenges due to anatomical distortions. Various patient and endoscopic factors, such as sex and positioning, may impact procedural success. It is unclear how these factors may impact the technical success of ERCP among patients with altered anatomy. Objective: We aimed to determine the patient and endoscopic factors that were associated with technical success of ERCP. Methods: We conducted a retrospective single-centre study using data from 2010 to 2020 that included patients with hepaticojejunostomy, Roux-en-Y anastomosis, Billroth-1, or Billroth-2 anatomy at a single tertiary care centre in Toronto, Canada. We extracted data from a database. The primary outcome was technical success of the ERCP, defined as successful navigation to the papilla or surgical anastomosis, selective cannulation and cholangiography or pancreatography. Penalized logistic regression with elastic net regularization was used to identify significant predictors of technical success. Effect size was odds ratio with 95% confidence interval. The model was evaluated using the area under the curve (AUC) metric. Results: Overall, there were 205 patients included in the analysis. In the multivariate analysis, the most significant contributors to predicting technical success of ERCP were expert endoscopic experience and non-Roux-en Y anatomy. The elastic net model demonstrated moderate predictive performance, with an AUC of 0.656. Conclusions: The findings emphasize the importance of tailored procedural planning to optimize ERCP success in patients with altered anatomy.

Indexed as

adverse eventsaltered anatomydouble balloon enteroscopyduodenoscopeendoscopist experienceERCPgastroscopeleft lateral decubitusprone

Identifiers

PMID40900918
PMCPMC12400998

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.