‘Short’ Double-Balloon Enteroscope for Endoscopic Retrograde Cholangiopancreatography in Patients with a Surgically Altered Upper Gastrointestinal Tract

Abstract

DBEs enable successful diagnostic and therapeutic ERCP in patients with a surgically altered anatomy of the upper gastrointestinal tract. It is a safe, feasible and less invasive therapeutic option in this group of patients. Standard 'long' DBEs have limitations of long working length and the need for modified ERCP accessories. 'Short' DBEs are equally as effective in reaching the target limb as standard 'long' DBEs, and overcomes some limitations of long DBEs to result in high success rates for endoscopic therapy.

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

“…Roux Th e time required to complete the DB-ERC procedure was comparable to or slightly shorter than previously reported times ( 36,40,41 ).…”

“…Osoegawara et al ( 40 ) reported the duration to reach the blind end was 30.5±3.7 min and the total duration of the procedure was 93.6±6.8 min Cho et al ( 41 ) reported the duration to reach the blind end was 20.8 min(range; 5-82 min), the total duration of the procedure was 70.7 min(range; 30-117 min) In our study, the time required to reach the blind end was 22.4±20.8 min (range; 2-114 min) and the total duration of the procedure was 78.5±38.1 min (range; 9-209 min), which were almost equivalent to or slightly shorter than durations from previously published papers. Th e duration time varied in a wide range, which suggested diffi cult cases required longer time to complete the procedures.…”

Approach of the Bile Duct by Gastrostomy in Patients With Bypass in Roux-en-Y Proved to Be Safe and Effective

“…The success rates obtained in the present study are similar to those described for the conventional method, for per-oral route; being superior to those obtained with the use of frontal vision devices [18,[19][20][21][22][23][24][25][26][27][28][29][30][31].…”

“…In this context, success rates of papillary or bile anastomosis range 55.0-100.0% in the series described in the literature, with catheterization rates, after reaching, above 90.0% [18][19][20][21][22][23][24][25][26][27][28][29][30][31], no identified significant difference between methods [28]. The high success rates of both papillary reach and bile duct catheterization should be attributed to the fact that most of the patients reported were not carriers of Roux-en-Y made with the purpose of weight loss, thus presenting segments of intestinal loops that make up the Y shorter, when compared to patients after bariatric surgery.…”

“…The high success rates of both papillary reach and bile duct catheterization should be attributed to the fact that most of the patients reported were not carriers of Roux-en-Y made with the purpose of weight loss, thus presenting segments of intestinal loops that make up the Y shorter, when compared to patients after bariatric surgery. Another determining factor in obtaining high success rates of papilla catheterization was the presence of digestive bile anastomoses instead of the native papilla in most patients [18][19][20][21][22][23][24][25][26][27][28][29][30][31]. Increased complication rates in these procedures, including perforation and pancreatitis, have also been reported [15,20,26,30,32,33].…”