{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T19:47:31Z","timestamp":1778010451593,"version":"3.51.4"},"reference-count":34,"publisher":"Georg Thieme Verlag KG","issue":"11","license":[{"start":{"date-parts":[[2024,10,17]],"date-time":"2024-10-17T00:00:00Z","timestamp":1729123200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Olympus Europa SE & CO. KG.","award":["Project ID 2021-0945"],"award-info":[{"award-number":["Project ID 2021-0945"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n            Background and study aims This was a prospective study of efficacy and safety of motorized spiral enteroscopy (MSE) to perform biliary endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy at five European centers.<\/jats:p><jats:p>\n            Patients and methods Consecutive patients with biliary indications for enteroscopy-assisted ERCP were enrolled. Objectives were technical success, adverse event (AE) rate, and patient radiation exposure.<\/jats:p><jats:p>\n            Results Eighty-nine patients were enrolled and one was excluded for a pancreatic indication. All participants had variations of Billroth II reconstruction (29.5%) or Roux-en-Y reconstruction (70.5%), either with naive papilla (39%) or hepaticojejunostomy (61%). Main indications were anastomotic stricture treatment and\/or biliary stone removal. Enteroscopy to reach the bile duct was possible in 65 of 88 patients (74%), bile duct cannulation in 54 of 88 (61%), and therapeutic ERCP was technically successful in 48 of 88 (54%). In Billroth II variations, technical success was achieved in 13 of 26 patients (50%) compared with 35 of 62 (57%, P = 0.5792 Chi square) in Roux-en-Y reconstructions (including bariatric gastric bypass). ERCP with intact papilla was successful in 17 of 34 patients (50%) compared with 31 of 54 (57%, P = 0.4968 Chi square) in hepaticojejunostomy. The study was prematurely terminated July 2023 because MSE was withdrawn by the manufacturer for safety issues. Overall, in 12 of 88 patients (14%), AEs were recorded and six (7%) were considered serious. Only one serious AE was attributable to MSE enteroscopy: perforation of the proximal esophagus during enteroscope insertion.<\/jats:p><jats:p>\n            Conclusions This prospective multicenter study was prematurely discontinued due to withdrawal of the MSE by the manufacturer because of safety issues. Technical success of MSE-assisted biliary ERCP in different types of surgically altered anatomy was 54%, which was lower than anticipated. There was one esophageal perforation attributable to use of MSE. 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Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Torsten","family":"Beyna","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Evangelisches Krankenhaus D\u00fcsseldorf, D\u00fcsseldorf, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,11,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1007\/s11894-013-0343-3","article-title":"ERCP in the patient with surgically altered anatomy","volume":"15","author":"TG Moreels","year":"2013","journal-title":"Curr Gastroenterol Rep"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1016\/j.giec.2022.02.001","article-title":"Biliary endoscopy in altered anatomy","volume":"32","author":"LY Zhang","year":"2022","journal-title":"Gastrointest Endosc Clin N Am"},{"key":"ref3","first-page":"1646","article-title":"Comparison between enteroscopy-, laparoscopy- and 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