title: Pancreatic endosonography after Billroth II gastrectomy.
abstract: OBJECTIVE
  Prior Billroth II gastrectomy is considered a relative contraindication to endoscopic ultrasonography (EUS) of the pancreatic head. This study reviews experience with pancreatic EUS in such patients.
  
  
  METHODS
  Eleven patients were identified who had previous Billroth II gastrectomy and underwent attempted pancreatic EUS.
  
  
  RESULTS
  Examination of the pancreatic head was technically feasible in 10 of the patients. The inferior pancreatic head, ampulla, and periampullary ducts were seen in all; the superior pancreatic head and porta hepatis were visualized in 50 % of cases with radial echo endoscopes and 100 % with a linear-array echo endoscope. The pancreatic neck was fully imaged in 25 % of cases with radial echo endoscopes and in 60 % with a linear-array echo endoscope. One known pancreatic neck mass was not visualized.
  
  
  CONCLUSIONS
  Pancreatic EUS is technically feasible in most patients with a prior Billroth II gastrectomy. Linear-array echo endoscopes provide a more complete examination than radial echo endoscopes. The pancreatic neck may be difficult to visualize.
authors.affiliation: Section of Digestive Diseases, Dept. of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
authors.forename: J H
authors.initials: JH
authors.lastname: Lee
authors.forename: M
authors.initials: M
authors.lastname: Topazian
mesh_terms: D000075202:Contraindications; D019160:Endosonography; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D010179:Pancreas / Q000000981:diagnostic imaging*; D010182:Pancreatic Diseases / Q000000981:diagnostic imaging