Ercp After Roux‐en‐y Reconstruction Can Be Carried Out Using an Oblique‐viewing Endoscope With an Overtube

Abstract

The results appear to support the feasibility of using an oblique-viewing endoscope for ERCP in Roux-en-Y reconstruction. Further studies including a large population of patients should be planned to confirm these results.

Diagnostic and Therapeutic Endoscopic Retrograde Cholangiography Using a Short-Type Double-Balloon Endoscope in Patients With Altered Gastrointestinal Anatomy: A Multicenter Prospective Study in Japan

“…Subsequent attempts have been made to perform ERC using standard side-viewing duodenoscopes, forward-viewing endoscopes and colonoscopes, with success rates of 50-92% ( 3,(7)(8)(9)(10)(11)(12). Th e fi rst use of ERC in patients who had undergone Rouxen-Y (R-Y) reconstruction was reported by Gostout and Bender in 1988 ( 13 ); subsequent attempts to perform ERC with duodenoscopes, pediatric-or adult-use colonoscopes, enteroscopes, ( 12,(14)(15)(16) and oblique-viewing endoscopes with an overtube ( 17 ) have achieved success rates of 33-67%. However, the success rates of these procedures are inadequate, and none have evolved to become standard care.…”

Therapeutic endoscopy for stenotic pancreatodigestive tract anastomosis after pancreatoduodenectomy (with videos)

“…However, with a forward-viewing endoscope, identifying the anastomosis and cannulating the main pancreatic duct via the anastomosis were difficult because of the sharp angulation required to observe the intestinal wall and the lack of a cannula deflector. 8 Under these considerations, an oblique-viewing endoscope that facilitates ERCP in Billroth II 13,14 or Roux-en-Y reconstruction 15 is considered ideal to cannulate the main pancreatic duct via the stenotic pancreatojejunostomy because it has a cannula deflector with good visibility for advancing into the GI lumen and observing the intestinal wall.…”

ERCP using a short double-balloon enteroscope in patients with prior pancreatoduodenectomy: higher maneuverability supplied by the efferent-limb route

“…To improve this technical success rate, a pediatric colonoscope [8], a duodenoscope [8,9], and an anterior oblique-viewing endoscope [10,11] have been used instead of the conventional front-viewing enteroscope [12]. Balloon enteroscopy has enabled endoscopists to access the papilla or biliopancreatoenteric anastomoses more definitively and safely [2][3][4][5], and has been commonly performed as the initial attempt to manage several postoperative disorders, in patients with not only Roux-en-Y reconstruction but also prior PD and Billroth II gastrectomy.…”