The utility of a multibending endoscope for selective cannulation during ERCP in patients with a Billroth II gastrectomy (with video).
BACKGROUND
Selective cannulation in patients with a Billroth II gastrectomy is still challenging.


OBJECTIVE
To evaluate the usefulness of a multibending, forward-viewing endoscope (M-scope) for selective cannulation during diagnostic or therapeutic ERCP in patients with a Billroth II gastrectomy.


METHODS
Case series.


METHODS
Tertiary center.


METHODS
Fourteen patients having biliary disease with a Billroth II gastrectomy in whom selective cannulation failed when using a conventional forward-viewing endoscope.


METHODS
In all cases, we attempted selective biliary cannulation for ERCP with a single-bending, forward-viewing endoscope for 10 minutes. After failure with the conventional endoscope, we retried selective cannulation with the M-scope for 10 minutes. After cannulation, the diagnostic or therapeutic endoscopic procedures were performed.


METHODS
We assessed the success rate of selective cannulation, the possibility of therapeutic approaches, and procedure-related complications.


RESULTS
In all cases, we successfully reached the ampulla of Vater with the M-scope. The overall success rate of selective cannulation with the M-scope was 92.9% (13/14). One patient developed mild pancreatitis. Therapeutic procedures such as sphincterotomy, balloon dilatation, stone removal, and biliary drainage were all possible.


CONCLUSIONS
Small number of patients; uncontrolled, single-center study.


CONCLUSIONS
The M-scope seems to be helpful for selective cannulation during ERCP in patients with a Billroth II gastrectomy. All diagnostic and therapeutic procedures were possible through the M-scope.
Koo
Hyun Cheol
HC
Department of Internal Medicine, Digestive Disease Center, Soon Chun Hyang University School of Medicine, Bucheon and Seoul, Korea.
Moon
Jong Ho
JH
Choi
Hyun Jong
HJ
Ko
Bong Min
BM
Hong
Su Jin
SJ
Cheon
Young Koog
YK
Cho
Young Deok
YD
Lee
Joon Seong
JS
Lee
Moon Sung
MS
Shim
Chan Sup
CS