Comparison of clinical outcomes for single- and double-balloon enteroscope-assisted endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND Balloon-assisted enteroscopy with a specialized overtube has improved the success of endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy (SAA). However, direct comparative data between double-balloon enteroscopy (DBE) and single-balloon enteroscopy (SBE) remain limited. AIM To compare the ERCP-related outcomes between DBE and SBE in patients with SAA. METHODS We retrospectively reviewed the medical records of 1042 patients with SAA who underwent ERCP. After propensity score matching for age and sex, 494 patients were included, with 247 patients in each of the SBE and DBE groups. RESULTS The success rates of intubation, cannulation, completion of intended ERCP, and adverse events were similar between the DBE and SBE groups (94.3% vs 96.4%, P = 0.393; 89.5% vs 93.5%, P = 0.147; 88.3% vs 92.7%, P = 0.125; 10.5% vs 14.6%, P = 0.222, respectively). However, the SBE group had significantly longer intubation and procedure times than the DBE group (23.5 ± 22.3 minutes vs 14.1 ± 13.5 minutes, P < 0.001; 65.2 ± 37.9 minutes vs 31.0 ± 18.5 minutes, P < 0.001). Preserved gastric anatomy and Roux-en-Y reconstruction were independently associated with intubation failure (odds ratio = 3.18, 95% confidence interval: 1.30-8.31; odds ratio = 8.65, 95% confidence interval: 1.71-157.60, respectively). CONCLUSION DBE and SBE showed comparable clinical success and safety profiles in ERCP for patients with SAA, although SBE required significantly longer procedure times. DBE could provide procedural efficiency benefits in cases where an extended procedure duration is expected. Furthermore, a preserved gastric anatomy and Roux-en-Y reconstruction were identified as independent risk factors for intubation failure.
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4415942865