Endoscopic examination of the common hepatic duct and cholangiography in a patient with previous Roux-en-Y hepaticojejunostomy and Billroth I operation

Effective ”short” double-balloon enteroscope for diagnostic and therapeutic ERCP in patients with altered gastrointestinal anatomy: a large case series

“…ERCP in patients with a Roux-en-Y reconstruction are challenging, with reported success rates ranging between 33 % and 67 % [4,6]. Several authors have described various approaches for inserting an endoscope to the blind end in these patients [1 -6], such as a technique in which an endoscope is inserted to the papilla and is then removed leaving the guide wire in place, followed by insertion of a side-viewing duodenoscope using the guide wire [6]; and techniques using a small-diameter colonoscope or a pediatric colonoscope [2,3]. Other recent reports describe the usefulness of a DBE in ERCP-related procedures in patients with previous pancreatobiliary disease who have undergone bowel reconstruction [14 -22].…”

Double‐balloon enteroscopy for choledochojejunal anastomotic stenosis after hepato‐biliary‐pancreatic operation

“…Endoscopic procedures for these patients are less invasive than surgical re‐anastomosis and IVR by PTC. However, it is difficult to accomplish endoscopic procedures for these patients using conventional enteroscopes because of the long length of the necessary passage, angulation of the anastomosis, and strong adhesion of the bowel to the peritoneum after reconstruction of the digestive tract …”

“…However, it is difficult to accomplish endoscopic procedures for these patients using conventional enteroscopes because of the long length of the necessary passage, angulation of the anastomosis, and strong adhesion of the bowel to the peritoneum after reconstruction of the digestive tract. [1][2][3][4][5][6] Since double-balloon enteroscopy (DBE) has been developed, 7 it is now possible to accomplish endoscopic retrograde cholangiopancreatography (ERCP) and its associated procedures for patients who have a reconstructed digestive tract with higher success rates. [8][9][10][11][12][13][14][15] However, there is no consensus on the procedures associated with DBE-ERCP, such as stent deployment and/or balloon dilation for these patients.…”

Motorized spiral enteroscopy-assisted ERCP in surgically altered anatomy: early experience from a retrospective cohort study

“…1 Several automatic motor stops in the same endoscope position led to termination of the procedure. 2 No advancement of the scope despite long spiral rotation in the same position led to termination of the procedure. 3 Including obtaining a ductogram.…”

“…Only a small group of patients is amenable to conventional endoscopic approaches after Billroth II resection. The majority of Billroth II resections and Roux-en-Y reconstructive surgery exclude the possibility of a subsequent conventional endoscopic approach for biliopancreatic systems [1][2][3][4]. Percutaneous [5], laparoscopic [6], and more recently endoscopic ultrasound (EUS)-guided transmural interventions [7] offer an alternative, but usually more invasive, approach.…”