Percutaneous-endoscopic rendezvous via cap-assisted adult colonoscope to deal with biliary and multiple intestine strictures after total gastrectomy.

Endoscopy

Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.

Published: October 2021

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Source
http://dx.doi.org/10.1055/a-1304-3304DOI Listing

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Article Synopsis
  • Complete esophageal obstruction (CEO) is a rare but serious complication from radiation therapy for esophageal or head and neck cancers, and managing it can be difficult using standard endoscopic methods.
  • A study on six patients demonstrated that a combined anterograde and retrograde endoscopic dilation (CARD) approach successfully restored esophageal function in 86% of cases, indicating high technical success.
  • While some adverse events occurred, including pneumothorax in two patients, most had improved swallowing abilities after the procedure, suggesting CARD is a safer and effective option compared to traditional methods.
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Objectives: Endoscopic ultrasound (EUS) or percutaneous-assisted antegrade guidewire insertion can be used to achieve biliary access when standard endoscopic retrograde cholangiopancreatography (ERCP) fails. We conducted a systematic review and meta-analysis to evaluate and compare the effectiveness and safety of EUS-assisted rendezvous (EUS-RV) and percutaneous rendezvous (PERC-RV) ERCP.

Methods: We searched multiple databases from inception to September 2022 to identify studies reporting on EUS-RV and PERC-RV in failed ERCP.

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