Efficacy and safety of endoscopic retrograde cholangiopancreatography in patients with Billroth II anastomosis.
OBJECTIVE
Endoscopic retrograde cholangiopancreatography (ERCP) procedure is quite difficult to perform in patients with Billroth II anastomosis because of anatomical alterations. The aim of this study is to evaluate retrospectively the results of ERCP applications done in patients with Billroth II operation.


METHODS
Out of the 1632 patients who underwent ERCP between 1992 and 2002, 27 (1.65%) had Billroth II operation. The records of these 27 patients were reviewed. Details noted included indications for ERCP, therapeutic interventions, causes of failure and complications.


RESULTS
Out of the patients, 3 were female and 24 male (mean age 62+/-11). 26 patients had extrahepatic biliary obstruction. 1 patient had an external bile drain. The procedure was carried out 1-5 times (mean 1.5+/-1.1). Cannulation was achieved in 17 patients (62.96%). Out of the patients cannulated, 10 had choledocholithiasis, 4 malign choledochal stricture, 1 chronic pancreatitis, 1 bile leak and 1 periampullary tumor. Success rate of endoscopic treatment was 82.35% (14/17). Proximal migration of the stent and hemorrhage in gastric cardia were the complications observed in the distinct patients.


CONCLUSIONS
ERCP procedure is quite an effective and safe method for diagnosis and treatment in patients with Billroth II anastomosis and extrahepatic cholestasis in spite of all difficulties.
Bagci
Sait
S
Gulhane Medical School, Department of Gastroenterology, Ankara, Turkey. saitbagci@yahoo.com
Tuzun
Ahmet
A
Ates
Yuksel
Y
Gulsen
Mustafa
M
Uygun
Ahmet
A
Yesilova
Zeki
Z
Karaeren
Necmettin
N
Dagalp
Kemal
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001660:Biliary Tract Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology / Q000601:surgery; D005763:Gastroenterostomy; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects; D017211:Treatment Failure; D016896:Treatment Outcome