title: Endoscopic retrograde cholangiopancreatography with single-balloon enteroscopy is feasible in patients with a prior Roux-en-Y anastomosis.
abstract: The purpose of this study is to describe the feasibility of using single-balloon enteroscopy (SBE) to perform endoscopic retrograde cholangiopancreatography (ERCP) in patients who had a prior Roux-en-Y (RY) anastomosis. This case series describes four patients, one with RY gastric bypass, two with RY due to bile duct injury, and one with RY after liver transplantation, who underwent ERCP with SBE. Cholangiography was successful in three of the four patients. In the procedure that was not successful, the enteroenterostomy site could not be located. The successful procedures ranged from 65-91 min in duration. Medication doses were higher than with typical ERCPs. No procedural complications occurred. SBE for ERCP is a feasible option for endoscopic access to the biliary tree in patients with prior RY anastomoses. Limitations of this technique include the time requirement, delay in identification of the enteroenterostomy site, potential learning curve, and immature technology lacking accessories.
authors.affiliation: Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, 130 Mason Farm Rd., Chapel Hill, NC 27599-7080, USA. edellon@med.unc.edu
authors.forename: Evan S
authors.initials: ES
authors.lastname: Dellon
authors.forename: Geoffrey P
authors.initials: GP
authors.lastname: Kohn
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Morgan
authors.forename: Ian S
authors.initials: IS
authors.lastname: Grimm
mesh_terms: D000328:Adult; D000713:Anastomosis, Roux-en-Y / Q000295:instrumentation* / Q000379:methods*; D001652:Bile Ducts / Q000293:injuries; D001653:Bile Ducts, Intrahepatic / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000295:instrumentation* / Q000379:methods*; D015209:Cholangitis, Sclerosing / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D008099:Liver / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged