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Utility of a Passive Bending Colonoscope for Endoscopic Retrograde Cholangiopancreatography in Patients with Surgically Altered Anatomy

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Abstract

Background and Aim

The utility of a passive bending colonoscope (PBCS) in ERCP for patients with surgically altered anatomy has not been established. This study compared the outcome of PBCS-ERCP and balloon-assisted enteroscope (BAE)-ERCP.

Methods

This multicenter observational study included 343 patients with surgically altered anatomy who underwent ERCP. Among these, 110 underwent PBCS-ERCP and 233 underwent BAE-ERCP. Propensity score matching was applied, and a final cohort of 210 (105 in each group) with well-balanced backgrounds was analyzed. The primary outcome was the success rate of reaching anastomosis or ampulla of Vater. Secondary endpoints included the cannulation success rate, completion rate, procedure time (to reach, cannulate, complete), and adverse events.

Results

The success rate for reaching the target was 91.4% (96/105) with PBCS and 90.5% (95/105) with BAE (odds ratio [95% CI] 1.12, [0.44–2.89], P = 0.809). The mean time required to reach the target was significantly shorter in PBCS: 10.04 min (SD, 9.62) with PBCS versus 18.77 min (SD, 13.21) with BAE (P < 0.001). There were no differences in the success of cannulation or procedure completion, although the required times for cannulation and procedure completion were significantly shorter in PBCS. The incidence of adverse events was significantly higher in BAE (19.0%) than in PBCS (4.8%; P < 0.001).

Conclusions

In patients with surgically altered anatomy, PBCS-ERCP showed promising results with shorter time to reach, cannulate, and a lower incidence of adverse events compared with BAE-ERCP. The success rate of reaching was favorable through PBCS compared with BAE.

Clinical Trial Registration

UMIN000045546.

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Funding

This work was supported by the Japan Gastroenterological Endoscopy Society Hokkaido Chapter, research grant 2022–2023.

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Authors and Affiliations

  1. Department of Gastroenterology, Sapporo City General Hospital, Kita 11, Nishi 13, Chuo-Ku, Sapporo, Hokkaido, 060-8604, Japan

    Shin Kato, Yuji Ono, Michio Nakamura, Ryo Fukino, Asako Nomura, Mariko Matsumura, Taichi Murai, Kazufumi Itaya, Yuta Koike, Takaaki Izumi, Ayana Endo & Shuji Nishikawa

  2. Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Hokkaido, Japan

    Masaki Kuwatani

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  1. Shin Kato
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  2. Yuji Ono
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Contributions

Conceptualization: SK; Data acquisition: SK, YO, RF, AN, MM, KI, YK, TI, AE, MK; Analysis of data: SK, YO, MN, MK; Funding acquisition: SK; Drafting: SK; Review and editing: SK, YO, MN, MM, KI, YK, TI, AE, MK, SN.

Corresponding author

Correspondence to Shin Kato.

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Authors declare no conflicts of interest for this article.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Institutional Review Boards of Sapporo City General Hospital (No. R04-063-956) and Hokkaido University Hospital (No. 021-0103).

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Kato, S., Ono, Y., Nakamura, M. et al. Utility of a Passive Bending Colonoscope for Endoscopic Retrograde Cholangiopancreatography in Patients with Surgically Altered Anatomy. Dig Dis Sci 69, 200–208 (2024). https://doi.org/10.1007/s10620-023-08163-1

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