Overtube-assisted ERCP in patients with altered gastric and esophageal anatomy.
BACKGROUND
ERCP has been a significant advance in the diagnosis and treatment of pancreatic and biliary diseases. However, anatomic variations may prevent successful ERCP.


METHODS
Advancement of a duodenoscope during ERCP was impeded in 4 patients by anatomic alterations of the esophagus and/or the stomach. The overtube, 80 cm length, was used to allow passage of a duodenoscope to the papilla.


RESULTS
All overtube assisted ERCP procedures were completed successfully and included sphincterotomy (2), bile duct stone extraction (2), and placement of a metal expandable stent (1).


CONCLUSIONS
Use of an overtube allows safe and successful passage of a duodenoscope in patients with anatomic alterations of the esophagus and/or the stomach.
Nawras
Ali T
AT
Pancreatic Biliary Center, St. Luke's Medical Center, Milwaukee, Wisconsin, USA.
Catalano
Marc F
MF
Alsolaiman
Mohammad M
MM
Rosenblatt
Mark L
ML
D000368:Aged; D000369:Aged, 80 and over; D001660:Biliary Tract Diseases / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000295:instrumentation*; D020698:Duodenoscopes; D004947:Esophagus / Q000002:abnormalities*; D005260:Female; D006801:Humans; D008297:Male; D010182:Pancreatic Diseases / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D013270:Stomach / Q000002:abnormalities*