Double balloon endoscopy increases the ERCP success rate in patients with a history of Billroth II gastrectomy

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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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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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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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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“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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A case of bile duct cancer developing 9 years after treatment of choledocholithiasis in a patient with a history of Billroth II gastrectomy

Progress of Digestive Endoscopy ◽

10.11641/pde.85.1_134 ◽

2014 ◽

Vol 85 (1) ◽

pp. 134-135

Author(s):

Takashi Taida ◽

Takao Nishikawa ◽

Toshio Tsuyuguchi ◽

Masato Nakamura ◽

Masaru Sakamoto ◽

...

Keyword(s):

Bile Duct ◽

Bile Duct Cancer ◽

Billroth Ii ◽

Billroth Ii Gastrectomy ◽

History Of ◽

Duct Cancer

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

The American Journal of Gastroenterology ◽

10.1038/ajg.2010.255 ◽

2010 ◽

Vol 105 (10) ◽

pp. 2294 ◽

Cited By ~ 9

Author(s):

Mitsunobu Matsushita ◽

Masaaki Shimatani ◽

Tsukasa Ikeura ◽

Makoto Takaoka ◽

Kazuichi Okazaki

Keyword(s):

Billroth Ii ◽

Double Balloon ◽

Billroth Ii Gastrectomy ◽

Single Balloon

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Acute Cholangitis following Biliary Obstruction after Duodenal OTSC Placement in a Case of Large Chronic Duodenocutaneous Fistula

Case Reports in Gastrointestinal Medicine ◽

10.1155/2015/647806 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4

Author(s):

Yaseen Alastal ◽

Tariq A. Hammad ◽

Mohamad Nawras ◽

Basmah W. Khalil ◽

Osama Alaradi ◽

...

Keyword(s):

Acute Cholangitis ◽

Eosinophilic Gastroenteritis ◽

Efficacy And Safety ◽

Duodenal Stump ◽

Billroth Ii ◽

Afferent Limb ◽

Billroth Ii Gastrectomy ◽

Close Proximity ◽

History Of ◽

Over The Scope Clip

Over-the-Scope Clip system, also called “Bear Claw,” is a novel endoscopic modality used for closure of gastrointestinal defect with high efficacy and safety. We present a patient with history of eosinophilic gastroenteritis and multiple abdominal surgeries including Billroth II gastrectomy complicated by a large chronic duodenocutaneous fistula from a Billroth II afferent limb to the abdominal wall. Bear Claw clip was used for closure of this fistula. The patient developed acute cholangitis one day after placement of the Bear Claw clip. Acute cholangitis due to papillary obstruction is a potential complication of Bear Claw placement at the dome of the duodenal stump (afferent limb) in patient with Billroth II surgery due to its close proximity to the major papilla.

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