Su1356 Single- and Double-Balloon Enteroscope for Therapeutic Endoscopic Retrograde Cholangiography After Roux-en-Y Small Bowel Surgery: a Single-Center Comparison

2013 ◽  
Vol 77 (5) ◽  
pp. AB296
Author(s):  
Tom G. Moreels ◽  
Elizabeth Macken ◽  
Sven M. Francque ◽  
Peter P. Michielsen ◽  
Paul A. Pelckmans
Keyword(s):  
Small Bowel ◽  
Endoscopic Retrograde Cholangiography ◽  
Single Center ◽  
Endoscopic Retrograde ◽  
Double Balloon ◽  
Bowel Surgery ◽  
Small Bowel Surgery

scholarly journals Double-balloon endoscopic retrograde cholangiography can make a reliable diagnosis and good prognosis for postoperative complications of congenital biliary dilatation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chiyoe Shirota ◽  
Hiroki Kawashima ◽  
Takahisa Tainaka ◽  
Wataru Sumida ◽  
Kazuki Yokota ◽  
...  
Keyword(s):  
Bile Duct ◽  
Postoperative Complications ◽  
Radical Surgery ◽  
Endoscopic Retrograde Cholangiography ◽  
Endoscopic Retrograde ◽  
Congenital Biliary Dilatation ◽  
Intrahepatic Stones ◽  
Biliary Dilatation ◽  
Double Balloon ◽  
Anastomotic Strictures

AbstractBile duct and anastomotic strictures and intrahepatic stones are common postoperative complications of congenital biliary dilatation (CBD). We performed double-balloon endoscopic retrograde cholangiography (DBERC) for diagnostic and therapeutic purposes after radical surgery. We focused on the effectiveness of DBERC for the treatment of postoperative complications of CBD patients. Bile duct and anastomotic strictures and intrahepatic stones are common postoperative complications of congenital biliary dilatation (CBD). We performed double-balloon endoscopic retrograde cholangiography (DBERC) for diagnostic and therapeutic purposes after radical surgery. We focused on the effectiveness of DBERC for the treatment of postoperative complications of CBD patients. This retrospective study included 28 patients who underwent DBERC (44 procedures) after radical surgery for CBD between January 2011 and December 2019. Strictures were diagnosed as “bile duct strictures” if endoscopy confirmed the presence of bile duct mucosa between the stenotic and anastomotic regions, and as “anastomotic strictures” if the mucosa was absent. The median patient age was 4 (range 0–67) years at the time of primary surgery for CBD and 27.5 (range 8–76) years at the time of DBERC. All anastomotic strictures could be treated with only by 1–2 courses of balloon dilatation of DBERC, while many bile duct strictures (41.2%) needed ≥ 3 treatments, especially those who underwent operative bile duct plasty as the first treatment (83.3%). Although the study was limited by the short follow-up period after DBERC treatment, DBERC is recommended as the first-line treatment for hepatolithiasis associated with biliary and anastomotic strictures in CBD patients, and it can be safely performed multiple times.

scholarly journals ‘Short’ Double-Balloon Enteroscope for Endoscopic Retrograde Cholangiopancreatography in Patients with a Surgically Altered Upper Gastrointestinal Tract

2011 ◽  
Vol 25 (11) ◽  
pp. 615-619 ◽  
Author(s):  
S Cho ◽  
P Kamalaporn ◽  
G Kandel ◽  
P Kortan ◽  
N Marcon ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Small Bowel ◽  
Upper Gastrointestinal Tract ◽  
Papilla Of Vater ◽  
Endoscopic Retrograde ◽  
Bilioenteric Anastomosis ◽  
Double Balloon ◽  
Surgically Altered Anatomy ◽  
Working Length ◽  
Upper Gastrointestinal

BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) remains a challenge for endoscopists in patients with surgically altered anatomy of the upper gastrointestinal tract. Double-balloon enteroscopes (DBEs) have revolutionized the ability to access the small bowel. The indication for its therapeutic use is expanding to include ERCP for patients who have undergone small bowel reconstruction. Most of the published experiences in DBE-assisted ERCP have used conventional double-balloon enteroscopes that are 200 cm in length, which do not permit use of the standard ERCP accessories. The authors report their experience with DBE-assisted ERCP using a ‘short’ DBE in patients with surgically altered anatomy.METHODS: A retrospective review of patients with previous small bowel reconstruction who underwent ERCP with a ‘short’ DBE at the Centre for Therapeutic Endoscopy and Endoscopic Oncology (Toronto, Ontario) between February 2007 and November 2008 was performed.RESULTS: A total of 20 patients (10 men) with a mean age of 57.9 years (range 26 to 85 years) underwent 29 sessions of ERCP with a DBE. Six patients underwent Billroth II gastroenterostomy, seven patients Roux-en-Y hepaticojejunostomy, five patients Roux-en-Y gastrojejunostomy, one patient Roux-en-Y esophagojejunostomy and one patient a Whipple’s operation with choledochojejunostomy. Some patients (n=12 [60%]) underwent previous attempts at ERCP in which the papilla of Vater or bilioenteric anastomosis could not be reached with either a duodenoscope or pediatric colonoscope. All procedures were performed with a commercially available DBE (working length 152 cm, distal end diameter 9.4 mm, channel diameter 2.8 mm). The procedures were performed under conscious sedation with intravenous midazolam, fentanyl and diazepam, except in one patient in whom general anesthesia was administered. Either the papilla of Vater or bilioenteric anastomosis was reached in 25 of 29 cases (86.2%) in a mean duration of 20.8 min (range 5 min to 82 min). Bile duct cannulation was successful in 24 of 25 cases in which the papilla or bilioenteric anastomosis was reached. Therapeutic interventions were successful in 15 patients (24 procedures) including sphincterotomy (n=7), stone extraction (n=9), biliary dilation (n=8), stent placement (n=9) and stent removal (n=8). The mean total duration of the procedures was 70.7 min (range 30 min to 117 min). There were no procedure-related complications.CONCLUSION: DBEs enable successful diagnostic and therapeutic ERCP in patients with a surgically altered anatomy of the upper gastrointestinal tract. It is a safe, feasible and less invasive therapeutic option in this group of patients. Standard ‘long’ DBEs have limitations of long working length and the need for modified ERCP accessories. ‘Short’ DBEs are equally as effective in reaching the target limb as standard ‘long’ DBEs, and overcomes some limitations of long DBEs to result in high success rates for endoscopic therapy.

Laparoscopic Small Bowel Surgery

2009 ◽  
pp. 312-312
Author(s):  
RK Mishra
Keyword(s):  
Small Bowel ◽  
Bowel Surgery ◽  
Small Bowel Surgery

Timing and Protocols of Endoscopic Follow-Up in Operated Patients After Small Bowel Surgery

2014 ◽  
pp. 41-48 ◽  
Author(s):  
Emanuele Rondonotti ◽  
Marco Pennazio
Keyword(s):  
Small Bowel ◽  
Bowel Surgery ◽  
Small Bowel Surgery

Anastomotic insufficiency in small bowel surgery ?incidence and treatment

1986 ◽  
Vol 368 (2) ◽  
pp. 105-111 ◽  
Author(s):  
W. L. E. M. Hesp ◽  
E. J. C. Lubbers ◽  
H. H. M. Boer ◽  
Th. Hendriks
Keyword(s):  
Small Bowel ◽  
Anastomotic Insufficiency ◽  
Bowel Surgery ◽  
Small Bowel Surgery ◽  
Surgery Incidence

scholarly journals Creation of a gastrogastric conduit by use of a lumen-apposing metal stent in a patient who had extensive small-bowel surgery secondary to a Peterson hernia

VideoGIE ◽  
2019 ◽  
Vol 4 (8) ◽  
pp. 369-371
Author(s):  
Emily Tucker ◽  
Simon Travis ◽  
Yutaro Higashi ◽  
Tim Bowling ◽  
Suresh Venkatachalapathy
Keyword(s):  
Small Bowel ◽  
Metal Stent ◽  
Bowel Surgery ◽  
Small Bowel Surgery
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