Endoscopic retrograde cholangiopancreatography in patients with Billroth II gastroenterostomy.
OBJECTIVE
Endoscopic retrograde cholangiopancreatography (ERCP) is more complicated in patients with Billroth II gastroenterostomy (B II GE) especially in those associated with Braun anastomosis (BA). The aim of the present study was to review experience of ERCP in patients with B II GE.


METHODS
The records of patients with B II GE who had undergone an ERCP within the last 2.5 years were retrospectively evaluated.


RESULTS
Fifty-two patients with simple B II GE and seven with additional BA underwent ERCP within this period. The probability of common bile duct cannulation and success of endoscopic treatment was 43/52 (83%) and 2/7 (29%) in the respective groups. The reasons for failure were long afferent loop in patients with BA; for the nine patients with B II GE the reasons for failure were tumoral infiltration at the orifice of afferent loop in one patient, peripapillary tumoral invasion in two patients, failure of entrance to the afferent loop due to angulation in two patients, and long afferent loop in the remaining four patients. Overall, perforation developed in 10.2% (6/59 of the patients. Two of these patients died (2/59, 3.4%) and one (1/59, 1.7%) had concomitant pancreatitis.


CONCLUSIONS
Although ERCP is successful in a large proportion of patients with B II GE, it carries significant risks such as perforation. ERCP must be performed by experienced endoscopists at institutions that have suitable facilities to manage endoscopy-related complications.
Ciçek
Bahattin
B
Department of Gastroenterology, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey. abcicek@ttnet.net.tr
Parlak
Erkan
E
Dişibeyaz
Selçuk
S
Koksal
Aydin Seref
AS
Sahin
Burhan
B
D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects / Q000379:methods; D005260:Female; D005763:Gastroenterostomy; D006801:Humans; D008297:Male; D008875:Middle Aged