Single-balloon enteroscopy-assisted ERCP in patients with Billroth II gastrectomy or Roux-en-Y anastomosis (with video)

Am J Gastroenterol. 2010 Jan;105(1):93-9. doi: 10.1038/ajg.2009.559. Epub 2009 Oct 6.

Abstract

Objectives: The aim of this study was to evaluate the usefulness of single-balloon enteroscopy (SBE)-assisted endoscopic retrograde cholangiopancreatography (ERCP) in patients with Billroth II gastrectomy (B-II) or Roux-en-Y anastomosis (R-Y).

Methods: Thirteen SBE procedures were performed in 2 patients with B-II and 11 patients with R-Y at Tokyo Medical University Hospital. SBE was replaced with a conventional forward-viewing upper endoscope after reaching the papilla. This is a retrospective cohort study.

Results: In all cases but one (92.3%, 12/13), the papilla or anastomotic site could be reached with the SBE. The rate for B-II and R-Y were 100% (2/2) and 90.9% (10/11), respectively. The mean time required to reach the papilla or anastomotic site was 33.3 min (range, 5-86 min). In cases of R-Y, the mean time required to reach the papilla or anastomotic site was 35.5 min (range, 12-76 min). The overall success rate of the therapeutic ERCP on the first session was 76.9% (10/13). In patients with an intact papilla, the success rate on the first session was 72.3% (8/11). With regard to the type of surgery, the success rate of the procedure in patients with B-II and R-Y was 100% (2/2) and 72.3% (8/11), respectively. The mean procedural time for 10 successful groups on the first session was 66.4 min (range, 25-152 min). No adverse events occurred.

Conclusions: SBE-assisted ERCP using an overtube-assisted technique appears to be promising for performing therapeutic ERCP in patients with B-II or R-Y.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anastomosis, Roux-en-Y*
  • Bile Duct Diseases / diagnostic imaging
  • Bile Duct Diseases / surgery*
  • Catheterization / instrumentation
  • Catheterization / methods*
  • Chi-Square Distribution
  • Cholangiopancreatography, Endoscopic Retrograde / methods*
  • Endoscopes, Gastrointestinal
  • Female
  • Gallbladder Neoplasms / diagnostic imaging
  • Gallbladder Neoplasms / surgery*
  • Gastroenterostomy / methods*
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome
  • Video Recording