“Short” Double-Balloon or Single-Balloon Enteroscope for ERCP in Patients With Billroth II Gastrectomy or Roux-en-Y Anastomosis

Objective: The aim of this study was to evaluate the difficulty of endoscopic retrograde cholangiopancreatography (ERCP) procedures when performed in patients with different types of surgically altered gastrointestinal (GI) anatomies. Summary of background data: Clinical data of 102 consecutive patients with surgically altered GI anatomy who underwent ERCP using a double-balloon enteroscope or a regular gastroendoscope between January 2008 and March 2015 were retrospectively reviewed. Methods: The success rate of reaching the destination, the time until reaching the destination, the success rate of the procedures, and complications were assessed for each type of altered GI anatomy using a double-balloon enteroscope and a regular gastroendoscope. Results: A total of 180 ERCP procedures were performed. The total success rate of reaching the destination was 91% (164 of 180), and that of treatment was 88% (144 of 164). The success rate of reaching the destination in patients with Roux-en-Y hepaticojejunostomy (HJ + R-Y) was significantly lower than that of the other types of reconstruction. The time until reaching the destination was significantly longer in patients after R-Y reconstruction (gastrectomy or HJ) than that after Billroth-II gastrectomy or pancreatoduodenectomy. GI perforation occurred in 2 patients after R-Y reconstruction (1 patient after gastrectomy, and 1 patient after HJ). However, no other complications, such as severe pancreatitis, bleeding, or air embolism, were observed. Conclusions: ERCP for patients with surgically altered GI anatomy is feasible. Improvement of the success rate of reaching the destination in patients after HJ + R-Y and prevention of perforation in those with R-Y reconstruction are necessary.

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ERCP plus papillotomy by use of double-balloon enteroscopy after Billroth II gastrectomy

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2007.04.030 ◽

2007 ◽

Vol 66 (6) ◽

pp. 1234-1236 ◽

Cited By ~ 23

Author(s):

Yen-Chang Chu ◽

Shin-Jung Su ◽

Chi-Chieh Yang ◽

Yung-Hsiang Yeh ◽

Chien-Hua Chen ◽

...

Keyword(s):

Billroth Ii ◽

Double Balloon Enteroscopy ◽

Balloon Enteroscopy ◽

Double Balloon ◽

Billroth Ii Gastrectomy

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Modified single-balloon endoscopy for ERCP in a patient with Billroth II gastrectomy

Endoscopy ◽

10.1055/s-0033-1344588 ◽

2014 ◽

Vol 46 (S 01) ◽

pp. E242-E243

Author(s):

Chen-Wang Chang ◽

Chien-Yuan Hung ◽

Tai-Cherng Liou ◽

Ching-Wei Chang ◽

Horng-Yuan Wang ◽

...

Keyword(s):

Billroth Ii ◽

Billroth Ii Gastrectomy ◽

Single Balloon

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M1479: ERCP With the Double Balloon Enteroscope in Patients With Billroth II Gastrectomy or Roux-en-Y Anastomosis

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2010.03.479 ◽

2010 ◽

Vol 71 (5) ◽

pp. AB232

Author(s):

Hirotoshi Okazaki ◽

Kazunari Tominaga ◽

Yasuaki Nagami ◽

Masami Nakatani ◽

Satoshi Sugimori ◽

...

Keyword(s):

Billroth Ii ◽

Double Balloon ◽

Billroth Ii Gastrectomy

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Utility of the Anterior Oblique-Viewing Endoscope and the Double-Balloon Enteroscope for Endoscopic Retrograde Cholangiopancreatography in Patients with Billroth II Gastrectomy

Gastroenterology Research and Practice ◽

10.1155/2012/389269 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Manabu Sen-yo ◽

Seiji Kaino ◽

Shigeyuki Suenaga ◽

Toshiyuki Uekitani ◽

Kanako Yoshida ◽

...

Keyword(s):

Success Rate ◽

Endoscopic Retrograde Cholangiopancreatography ◽

Control Group ◽

Endoscopic Retrograde ◽

Billroth Ii ◽

Double Balloon ◽

Billroth Ii Gastrectomy ◽

Selective Cannulation ◽

Historical Controls

Background/Purpose. The difficulties of endoscopic retrograde cholangiopancreatography in patients with Billroth II gastrectomy have been reported. We evaluated the usefulness of an anterior oblique-viewing endoscope and a double-balloon enteroscope for endoscopic retrograde cholangiopancreatography in such patients.Methods. From January 2003 to December 2011, 65 patients with Billroth II gastrectomy were enrolled in this study. An anterior oblique-viewing endoscope was used for all patients. From February 2007, a double-balloon enteroscope was used for the failed cases. The success rate of procedures was compared with those in 20 patients with Billroth II gastrectomy using forward-viewing endoscope or side-viewing endoscope from March 1996 to July 2002 as historical controls.Results. In all patients in whom the papilla was reached (60/65), selective cannulation was achieved. The success rate of selective cannulation and accomplishment of planned procedures in the anterior oblique-viewing endoscope group were both significantly higher than that in the control group (100% versus 70.1%, 100 versus 58.8%, resp.). A double-balloon enteroscope was used in 2 patients, and the papilla could be reached and the planned procedures completed.Conclusions. An anterior oblique-viewing endoscope and double-balloon enteroscope appear to be useful in performing endoscopic retrograde cholangiopancreatography in patients with Billroth II gastrectomy.

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“Short” double balloon enteroscope for endoscopic retrograde cholangiopancreatography with conventional sphincterotomy and metallic stent placement after Billroth II gastrectomy

Endoscopy ◽

10.1055/s-0028-1103466 ◽

2009 ◽

Vol 41 (S 02) ◽

pp. E19-E20 ◽

Cited By ~ 10

Author(s):

M. Shimatani ◽

M. Matsushita ◽

M. Takaoka ◽

T. Kusuda ◽

N. Fukata ◽

...

Keyword(s):

Endoscopic Retrograde Cholangiopancreatography ◽

Stent Placement ◽

Metallic Stent ◽

Endoscopic Retrograde ◽

Billroth Ii ◽

Double Balloon ◽

Billroth Ii Gastrectomy ◽

Metallic Stent Placement

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Single-Balloon Enteroscopy–Assisted ERCP in Patients With Billroth II Gastrectomy or Roux-en-Y Anastomosis (With Video)

The American Journal of Gastroenterology ◽

10.1038/ajg.2009.559 ◽

2010 ◽

Vol 105 (1) ◽

pp. 93-99 ◽

Cited By ~ 121

Author(s):

Takao Itoi ◽

Kentaro Ishii ◽

Atsushi Sofuni ◽

Fumihide Itokawa ◽

Takayoshi Tsuchiya ◽

...

Keyword(s):

Billroth Ii ◽

Balloon Enteroscopy ◽

Billroth Ii Gastrectomy ◽

Single Balloon ◽

Single Balloon Enteroscopy

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Does Single-Balloon Enteroscopy Contribute to Successful Endoscopic Retrograde Cholangiopancreatography in Patients with Surgically Altered Gastrointestinal Anatomy?

ISRN Gastroenterology ◽

10.1155/2013/214958 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 10

Author(s):

Takuji Kawamura ◽

Koichiro Mandai ◽

Koji Uno ◽

Kenjiro Yasuda

Keyword(s):

Endoscopic Retrograde Cholangiopancreatography ◽

Group Versus ◽

Red Cross ◽

Endoscopic Retrograde ◽

Billroth Ii ◽

Balloon Enteroscopy ◽

Billroth Ii Gastrectomy ◽

Significant Difference ◽

Single Balloon ◽

Single Balloon Enteroscopy

Background. Balloon-assisted enteroscopy has been recognized as a useful method for performing endoscopic retrograde cholangiopancreatography in patients with complex postsurgical anatomy. Objective. To clarify the usefulness of single-balloon enteroscopy for performing endoscopic retrograde cholangiopancreatography successfully in patients after Billroth II gastrectomy or Roux-en-Y reconstruction and compare it with that of conventional endoscopy. Patients and Methods. We analyzed 204 endoscopic retrograde cholangiopancreatography procedures performed at Kyoto Second Red Cross Hospital between 1997 and 2011 in 93 patients after Billroth II gastrectomy and Roux-en-Y reconstruction with gastrectomy and choledochojejunostomy. We compared recent results with those achieved before the advent of single-balloon enteroscopy (“pre-single-balloon enteroscopy” group versus “post-single-balloon enteroscopy” group). Results. The rate of reaching the blind end was 11/12 (91.7%) in post-single-balloon enteroscopy Roux-en-Y gastrectomy cases and 3/9 (33.3%) in pre-single-balloon enteroscopy Roux-en-Y gastrectomy cases (). The rate of accomplishing target procedures was 7/12 (58.3%) in post-single-balloon enteroscopy Roux-en-Y gastrectomy cases. No significant difference was found in the rates for Billroth II gastrectomy cases. Conclusion. The single-balloon enteroscopy system is effective in reaching the blind end in patients who have undergone Roux-en-Y reconstruction; however, further innovations are needed to accomplish endoscopic retrograde cholangiopancreatography-related procedures.

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