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Procedural Outcomes of Laparoscopic-Assisted Endoscopic Retrograde Cholangiopancreatography in Patients with Previous Roux-en-Y Gastric Bypass Surgery: a Systematic Review and Meta-analysis

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Abstract

Purpose

To investigate the procedural outcomes of laparoscopic-assisted endoscopic retrograde cholangiopancreatography (ERCP) in patients with previous Roux-en-Y gastric bypass (RYGB) surgery.

Materials and Methods

We performed a systematic review in accordance with PRISMA statement standards to identify all studies reporting procedural outcomes of laparoscopic-assisted ERCP in patients with previous RYGB. The ROBINS-I tool was used to assess the risk of bias of the included studies. Fixed-effect and random-effects models were applied to calculate pooled outcome data.

Results

A total of 17 case series, enrolling 256 patients, were included. The mean age of included patients was 49. The mean procedure time was 137 min (95% CI 102–172). In terms of procedural success rates, the overall technical success was 95.3% (95% CI 92.5–97.5, I2 = 0%), papillary access success was 95.3% (95% CI 92.5–97.5, I2 = 0%), cannulation success was 95.3% (95% CI 92.5–97.5, I2 = 0%), sphincterotomy success was 96.1% (95% CI 93.5–98.1, I2 = 0%), and stone removal success was 95.9% (95% CI 92.4–98.4, I2 = 0%). Conversion to open was required in 4.7% (95% CI 2.5–7.6, I2 = 0%). In terms of complications, pancreatitis occurred in 4.7% (95% CI 2.3–8, I2 = 17%), cholangitis in 1.7% (95% CI 0.5–3.6, I2 = 0%), and perforation in 3.7% (95% CI 1.8–6.3, I2 = 0%). The length of hospital stay was 3 days (95% CI 2–4).

Conclusions

Laparoscopic-assisted ERCP seems to be feasible, effective, and a safe method to access the biliary tract in patients with previous RYGB as indicated by high technical success rates and low complication rates. There is a need for comparative evidence regarding outcomes of laparoscopic ERCP in comparison with alternative treatment options.

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Author information

Author notes

  1. Shahab Hajibandeh and Shahin Hajibandeh contributed equally to this work.

Authors and Affiliations

  1. Department of General Surgery, Glan Clwyd Hospital, Rhyl, Denbighshire, UK

    Shahab Hajibandeh

  2. Department of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK

    Shahin Hajibandeh

  3. Department of Hepatobiliary and Pancreatic Surgery, Manchester Royal Infirmary Hospital, Manchester, UK

    Munir Tarazi & Thomas Satyadas

  4. Department of Upper Gastrointestinal Surgery, North Manchester General Hospital, Manchester, UK

    Moustafa Mansour

Authors
  1. Shahab Hajibandeh
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  2. Shahin Hajibandeh
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  3. Munir Tarazi
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  4. Moustafa Mansour
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  5. Thomas Satyadas
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Contributions

Conception and design: Shahab H, TS.

Data collection: Shahab H, Shahin H, MT.

Analysis and interpretation: All authors.

Writing the article: Shahab H, Shahin H, MT.

Critical revision of the article: All authors.

Final approval of the article: All authors.

Statistical analysis: Shahab H, Shahin H.

Corresponding author

Correspondence to Shahab Hajibandeh.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

Considering the nature of this study, ethical approval was not required.

Human and Animal Rights

This study is a systematic review with meta-analysis of outcomes which does not include research directly involving human or animal participation.

Informed Consent

Considering the nature of this study, informed consent was not required.

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Appendix A

Appendix A

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Hajibandeh, S., Hajibandeh, S., Tarazi, M. et al. Procedural Outcomes of Laparoscopic-Assisted Endoscopic Retrograde Cholangiopancreatography in Patients with Previous Roux-en-Y Gastric Bypass Surgery: a Systematic Review and Meta-analysis. OBES SURG 31, 282–298 (2021). https://doi.org/10.1007/s11695-020-04954-x

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