Top

Journal of Hepato-Biliary-Pancreatic Sciences

Published in:

01-09-2009 | Topics

ERCP using double-balloon endoscopes in patients with Roux-en-Y anastomosis

Authors: Shomei Ryozawa, Sayaka Iwamoto, Hirotoshi Iwano, Noriko Ishigaki, Kumiko Taba, Isao Sakaida

Published in: Journal of Hepato-Biliary-Pancreatic Sciences | Issue 5/2009

Abstract

Introduction

Endoscopic retrograde cholangiopancreatography (ERCP) and associated procedures are difficult to perform in patients with a Roux-en-Y reconstruction. Therefore, at present, at many institutions, ERCP is not generally performed for those with a Roux-en-Y anastomosis.

Methods

However, double-balloon endoscopes (DBEs) have dramatically changed this situation.

Results

The use of a DBE enables an endoscopic approach into the deeply situated small intestine, which has been difficult with a conventional endoscope. Therefore, ERCP for patients with a Roux-en-Y anastomosis has been attempted using a DBE, and good results have been reported.

Conclusion

The development of DBEs has created the possibility of performing ERCP for patients with Roux-en-Y reconstruction in whom an endoscopic approach has conventionally been believed to be difficult.

Hintze RE, Adler A, Veltzke W, Abou-Rebyeh H. Endoscopic access to the papilla of Vater for endoscopic retrograde cholangiopancreatography in patients with Billroth II or Roux-en-Y gastrojejunostomy. Endoscopy. 1997;29:69–73.PubMedCrossRef

Wright BE, Cass OW, Freeman ML. ERCP in patients with long-limb Roux-en-Y gastrojejunostomy and intact papilla. Gastrointest Endosc. 2002;56:225–32.PubMedCrossRef

Gostout CJ, Bender CE. Cholangiopancreatography, sphincterotomy, and common duct stone removal via Roux-en-Y limb enteroscopy. Gastroenterology. 1988;95:156–63.PubMed

Elton E, Hanson BL, Qaseem T, Howell DA. Diagnostic and therapeutic ERCP using an enteroscope and a pediatric colonoscope in long-limb surgical bypass patients. Gastrointest Endosc. 1998;47:62–7.PubMedCrossRef

Hirai R, Kikuyama M, Sato K, Haruki M, Sakai S, Koide S, et al. An oblique-viewing endoscope with an overtube facilitate bile duct stone removal in Roux-en-Y gastrectomy patients (in Japanese with English abstract). Gastroenterol Endosc. 2006;48:212–6.

Yamamoto H, Sekine Y, Sato Y, Higashizawa T, Miyata T, Iino S, et al. Total enteroscopy with a nonsurgical steerable double-balloon method. Gastrointest Endosc. 2001;53:216–20.PubMedCrossRef

Yamamoto H, Yano T, Kita H, Sunada K, Ido K, Sugano K. New system of double-balloon enteroscopy for diagnosis and treatment of small intestinal disorders. Gastroenterology. 2003;125:1556–7.PubMedCrossRef

Haruta H, Yamamoto H, Mizuta K, Kita Y, Uno T, Egami S, et al. A case of successful enteroscopic balloon dilation for late anastomotic stricture of choledochojejunostomy after living donor liver transplantation. Liver Transpl. 2005;11:1608–10.PubMedCrossRef

Spahn TW, Grosse-Thie W, Spies P, Mueller MK. Treatment of choledocholithiasis following Roux-en-Y hepaticojejunostomy using double-balloon endoscopy. Digestion. 2007;75:20–1.PubMedCrossRef

10.

Aabakken L, Bretthauer M, Line PD. Double-balloon enteroscopy for endoscopic retrograde cholangiography in patients with a Roux-en-Y anastomosis. Endoscopy. 2007;39:1068–71.PubMedCrossRef

11.

Emmett DS, Mallat DB. Double-balloon ERCP in patients who have undergone Roux-en-Y surgery: a case series. Gastrointest Endosc. 2007;66:1038–41.PubMedCrossRef

12.

Moreels TG, Roht B, Vandervliet EJ, Parizel PM, Dutré J, Pelckmans PA. The use of the double-balloon enteroscope for endoscopic retrograde cholangiopancreatography and biliary stent placement after Roux-en-Y hepaticojejunostomy. Endoscopy. 2007;39(suppl 1):E196–7.PubMedCrossRef

13.

Mönkemüller K, Bellutti M, Neumann H, Malfertheiner P. Therapeutic ERCP with the double-balloon enteroscope in patients with Roux-en-Y anastomosis. Gastrointest Endosc. 2008;67:992–6.PubMedCrossRef

14.

Chu YC, Yang CC, Yeh YH, Chen CH, Yueh SK. Double-balloon enteroscopy application in biliary tract disease–its therapeutic and diagnostic functions. Gastrointest Endosc. 2008;68:585–91.PubMedCrossRef

15.

Matsushita M, Shimatani M, Takaoka M, Okazaki K. “Short” double-balloon enteroscope for diagnostic and therapeutic ERCP in patients with altered gastrointestinal anatomy. Am J Gastroenterol. 2008;103:3218–9.PubMedCrossRef

16.

Koornstra JJ. Double balloon enteroscopy for endoscopic retrograde cholangiopancreaticography after Roux-en-Y reconstruction: case series and review of the literature. Neth J Med. 2008;66:275–9.PubMed

17.

Ryozawa S, Iwamato S, Urayama N, Iwano H, Harano M, Ishigaki N, et al. Diagnostic and therapeutic endoscopy using a double balloon endoscope in long-limb surgical bypass patients: focusing on ERCP in patients with Roux-en-Y gastrojejunostomy (in Japanese with English abstract). Shokaki Naishikyo (Endoscopia Digestiva). 2007;19:1611–8.

18.

Joyce AM, Ahmad NA, Beilstein MC, Kochman ML, Long WB, Baron T, et al. Multicenter comparative trial of the V-scope system for therapeutic ERCP. Endoscopy. 2006;38:713–6.PubMedCrossRef

Title: ERCP using double-balloon endoscopes in patients with Roux-en-Y anastomosis
Authors: Shomei Ryozawa
Sayaka Iwamoto
Hirotoshi Iwano
Noriko Ishigaki
Kumiko Taba
Isao Sakaida
Publication date: 01-09-2009
Publisher: Springer Japan
Published in: Journal of Hepato-Biliary-Pancreatic Sciences / Issue 5/2009
Print ISSN: 1868-6974
Electronic ISSN: 1868-6982
DOI: https://doi.org/10.1007/s00534-009-0132-4

At a glance: The STEP trials

Springer Medicine

ERCP using double-balloon endoscopes in patients with Roux-en-Y anastomosis

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 5/2009

A pancreaticoduodenectomy is acceptable for periampullary tumors in the elderly, even in patients over 80 years of age

Treatment of pancreatic fistula after pancreatoduodenectomy using a hand-made T-tube

Tolerance of radiofrequency ablation by patients of hepatocellular carcinoma

Single-port endoscopic cholecystectomy: a bridge between laparoscopic and translumenal endoscopic surgery

Gastrointestinal bleeding in a pregnant woman: mucinous cystic neoplasm of pancreas mimicking gastrointestinal stromal tumor of stomach

Covered metallic stents in the management of malignant and benign pancreatobiliary strictures