Double-balloon Endoscopy for Retrograde Cholangiography in Patients with Choledochojejunostomy and Roux-en-Y Reconstruction

Abstract

The DBE system permits diagnostic and therapeutic ERC in surgically modified anatomy, previously unavailable for endoluminal access. In our experience this procedure is safe and has a high success rate with a favourable patient outcome.

Long- and short-type double-balloon enteroscopy-assisted therapeutic ERCP for intact papilla in patients with a Roux-en-Y anastomosis

“…However, recently developed DBE systems have made it possible to reach the papilla or biliopancreatoenteric anastomosis site with certainty even in patients with Roux-en-Y surgical anastomoses [10–23] (Table 3). In particular, sharp angulation of the Roux limb in any given case may make it difficult to negotiate the passage of the scope to the papilla even for skilled endoscopists.…”

Single Balloon Enteroscopy for Endoscopic Retrograde Cholangiography in a Patient with Hepaticojejunostomy after Liver Transplant

“…For example, pediatric colonoscopes have been used to reach the Roux-en-Y limb in these patients. Other techniques described are balloon-assisted endoscopes or double-balloon enteroscopes [13–15]. Also, in selected cases, double-balloon enteroscopes combined with a percutaneous rendezvous technique may be helpful, as illustrated in the only case reported in the literature [16].…”

Double-balloon enteroscopy-assisted endoscopic retrograde cholangiography for Roux-en-Y reconstruction patients with papilla of Vater or bilioenteric anastomosis

“…Performing ERC in such patients is a challenge since it is difficult to access the afferent limb by a duodenoscope, a push enteroscope or a pediatric colonoscope [4][5][6][7]. The introduction of a double-balloon enteroscope (DBE) allows access to areas beyond the reach of these conventional endoscopes and renders ERC more feasible in patients with Roux-en-Y reconstruction [8][9][10][11][12][13][14].…”

“…Therefore, the results of double-balloon enteroscopy-assisted ERC (DBE-ERC) between patients with IPV and BEA may be different but lack studies. Literature review revealed that some series included only patients with IPV [13], others included only patients with BEA [10,12], and still others included mixed patients with a Billroth II gastrectomy and Whipple operation [11,14,16]. Besides, most were small series with less than 20 patients [8][9][10]12,13].…”