Understanding the Role of Different ERCP Techniques in Post-Roux-en-Y Gastric Bypass Patients: a Systematic Review and Meta-analysis

Bálint Gellért; Anett Rancz; Jakub Hoferica; Brigitta Teutsch; Zoltán Sipos; Dániel S Veres; Péter Jenő Hegyi; Szabolcs Ábrahám; Péter Hegyi; István Hritz

doi:10.1007/s11695-024-07459-z

Understanding the Role of Different ERCP Techniques in Post-Roux-en-Y Gastric Bypass Patients: a Systematic Review and Meta-analysis

Obes Surg. 2025 Jan;35(1):285-304. doi: 10.1007/s11695-024-07459-z. Epub 2024 Dec 13.

Authors

Bálint Gellért^{1

2}, Anett Rancz^{1

3}, Jakub Hoferica^{1

4}, Brigitta Teutsch^{1

5

6}, Zoltán Sipos^{5

7}, Dániel S Veres⁸, Péter Jenő Hegyi^{1

9}, Szabolcs Ábrahám¹⁰, Péter Hegyi^{1

5

9

11}, István Hritz¹²

Affiliations

¹ Centre for Translational Medicine, Semmelweis University, Üllői Út 26, 1085, Budapest, Hungary.
² Department of Surgery, Transplantation and Gastroenterology, Division of Interventional Gastroenterology, Semmelweis University, Üllői Út 78, 1082, Budapest, Hungary.
³ Department of Internal Medicine and Hematology, Medical School, Semmelweis University, Üllői Út 26, 1085, Budapest, Hungary.
⁴ Jessenius Faculty of Medicine in Martin, Comenius University, Malá Hora 4A, 036 01, Martin-Záturčie, Slovakia.
⁵ Institute for Translational Medicine, Medical School, University of Pécs, Szigeti Út 12, 7624, Pécs, Hungary.
⁶ Department of Radiology, Medical Imaging Centre, Semmelweis University, Korányi Sándor U. 2, 1082, Budapest, Hungary.
⁷ Institute of Bioanalysis, Medical School, University of Pécs, Honvéd Utca 1, 7624, Pécs, Hungary.
⁸ Department of Biophysics and Radiation Biology, Semmelweis University, Tűzoltó U. 37-47, 1094, Budapest, IX, Hungary.
⁹ Institute of Pancreatic Diseases, Semmelweis University, Tömő Utca 25-29, 1083, Budapest, Hungary.
¹⁰ Department of Surgery, Albert Szent-Györgyi Medical School, University of Szeged, H-6725 Tisza Utca 109, Szeged, Hungary.
¹¹ Translational Pancreatology Research Group, Interdisciplinary Centre of Excellence for Research Development and Innovation, University of Szeged, H-6725 Tisza Utca 109, Szeged, Hungary.
¹² Department of Surgery, Transplantation and Gastroenterology, Division of Interventional Gastroenterology, Semmelweis University, Üllői Út 78, 1082, Budapest, Hungary. [email protected].

Abstract

We aimed to compare enteroscopy-assisted ERCP (EA-ERCP), laparoscopy-assisted ERCP (LA-ERCP), and endoscopic ultrasound-directed ERCP (EDGE) in terms of safety and efficacy in post-Roux-en-Y gastric bypass patients. We conducted a rigorous analysis based on a predefined protocol (PROSPERO, CRD42022368788). Sixty-seven studies were included. The technical success rates were 77% (CI 69-83%) for EA-ERCP, 93% (CI 91-96%) for LA-ERCP, and 96% (CI 92-98%) for EDGE. Subgroup differences were significant between the EA-ERCP and other groups (p < 0.05). The overall adverse event rates were 13% (CI 8-22%), 19% (CI 14-24%), and 20% (CI 12-31%), respectively (p = 0.49). Our findings suggest that EDGE and LA-ERCP may be more effective and as safe as EA-ERCP.

Keywords: ERCP; Endoscopic ultrasound; Enteroscopy; Laparoscopy; Surgically altered anatomy.

Publication types

Systematic Review
Meta-Analysis
Comparative Study
Review

MeSH terms

Adult
Cholangiopancreatography, Endoscopic Retrograde* / methods
Endosonography
Female
Gastric Bypass* / methods
Humans
Laparoscopy* / methods
Male
Middle Aged
Obesity, Morbid* / surgery
Postoperative Complications / epidemiology
Treatment Outcome

Grants and funding

BT - ÚNKP-23-3-II-PTE-1996/Innovációs és Technológiai Minisztérium