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

Lin, Cheng Hui; Tang, Jui-Hsiang; Cheng, Ching‐Yi; Tsou, Yung Kuan; Ho, Cheng; Lee, Mu Hsien; Sung, Kai Feng; Lee, Ching Song; Liu, Nai Jen

doi:10.3748/wjg.v16.i36.4594

Cited by 18 publications

(17 citation statements)

References 19 publications

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“…The few studies published have had varying success rates, and most of them have been case series with limited numbers of patients. [7][8][9][10][11][12][13][14] These studies all have been done in a diverse cohort of patients who have had various forms of surgery ranging from Billroth II resections, gastric bypass surgery, and Roux-en-Y anastomosis. To date, quoted success rates of successful intubation of the excluded limb, successful cannulation, and successful therapy have ranged from 60% to 98%, depending on the endoscope used, the original anatomy altering surgery, whether or not the papilla was intact, and the intervention attempted.…”

Section: Discussionmentioning

confidence: 99%

“…More recently, promising studies with doubleballoon enteroscopy (DBE), described in 2001 by Yamamoto et al, 5 and with single-balloon enteroscopy (SBE), 6 have suggested that both modalities can be used to access the Roux limb as well as the biliary tree in surgically altered anatomy. [7][8][9][10][11][12][13][14] In addition, diagnostic and therapeutic ERCPs can be performed with success rates of up to 81% with SBE and 98% with DBE.…”

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confidence: 99%

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Balloon-assisted enteroscopy in patients with surgically altered anatomy: a liver transplant center experience (with video)

Chua

Kaffes

2012

Gastrointestinal Endoscopy

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Balloon-assisted enteroscopy in patients with surgically altered anatomy: a liver transplant center experience (with video)

Chua

Kaffes

2012

Gastrointestinal Endoscopy

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“…For expert endoscopists, the procedure has the same level of difficulty as in a patient with normal anatomy, so they usually recommend using a side-viewing duodenoscope because the endoscope has an elevator and large accessory channel 8,9. Of course, the skill of the experienced endoscopist is an important factor in the safety of the procedure and complication rates for diagnostic or therapeutic ERCP 3,8,10-12…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Forward-Viewing Endoscope for Endoscopic Retrograde Cholangiopancreatography in Patients with Billroth II Gastrectomy

et al. 2012

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Background/AimsPatients undergoing Billroth II (B II) gastrectomy are at higher risk of perforation during endoscopic retrograde cholangiopancreatography (ERCP). We assessed the success rate and safety of forward-viewing endoscopic biliary intervention in patients with B II gastrectomy.MethodsA total of 2,280 ERCP procedures were performed in our institution between October 2008 and June 2011. Of these, forward-viewing endoscopic biliary intervention was performed in 46 patients (38 men and 8 women with B II gastrectomy). Wire-guided selective cannulations of the common bile duct using a standard catheter and guide wire were performed in all patients.ResultsThe success rate of afferent loop entrance was 42 out of 46 patients (91.3%) and of biliary cannulation after the approach of the papilla was 42 out of 42 patients (100%). No serious complications were encountered, except for one case of small perforation due to endoscopic sphincterotomy site injury.ConclusionsWhen a biliary endoscopist has less experience and patient volume is low, ERCP with a forward-viewing endoscope is preferred because of its ease and safety in all patients with prior B II gastrectomies. Also, forward-viewing endoscope can be used to improve the success rate of biliary intervention in B II patients.

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“…Moreover, complications such as perforation during insertion can occur in patients with postoperative adhesions. All relevant reports are case series, and they document 54-62% success in reaching the papilla and 100% treatment success in patients with previous Roux-en-Y anastomosis [149][150][151][152], and corresponding rates of 89% and 100% in patients with previous Billroth II gastrectomy [153][154][155][156][157]. These ERCP case series included only a small number of Roux-en-Y anastomosis patients (6 of 32 procedures) and Billroth II gastrectomy patients (9 of 43 procedures); no serious complications were reported.…”

Section: Commentarymentioning

confidence: 99%

Evidence-based clinical practice guidelines for cholelithiasis 2016

Tazuma

Unno²,

Igarashi³

et al. 2016

J Gastroenterol

214

178

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Cholelithiasis is one of the commonest diseases in gastroenterology. Remarkable improvements in therapeutic modalities for cholelithiasis and its complications are evident. The Japanese Society of Gastroenterology has revised the evidence-based clinical practice guidelines for cholelithiasis. Forty-three clinical questions, for four categories-epidemiology and pathogenesis, diagnosis, treatments, and prognosis and complications-were selected, and a literature search was performed for the clinical questions with use of the MEDLINE, Cochrane, and Igaku Chuo Zasshi databases for the period between 1983 and June 2012. The guidelines were developed with use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. This article preferentially describes the clinical management of cholelithiasis and its complications. Following description of the diagnosis performed stepwise through imaging modalities, treatments of cholecystolithiasis, choledocholithiasis, and hepatolithiasis are introduced along with a flowchart. Since there have been remarkable improvements in endoscopic treatments and surgical techniques, the guidelines ensure flexibility in choices according to the actual clinical environment. The revised clinical practice guidelines are appropriate for use by clinicians in their daily practice.

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

Abstract: The overall ERCP success rate increases with DBE in patients with a previous B II gastrectomy.

Cited by 18 publications

References 19 publications

Balloon-assisted enteroscopy in patients with surgically altered anatomy: a liver transplant center experience (with video)

Balloon-assisted enteroscopy in patients with surgically altered anatomy: a liver transplant center experience (with video)

Usefulness of Forward-Viewing Endoscope for Endoscopic Retrograde Cholangiopancreatography in Patients with Billroth II Gastrectomy

Evidence-based clinical practice guidelines for cholelithiasis 2016

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