Endoscopic retrograde cholangiography by double balloon enteroscopy in patients with Roux-en-Y hepaticojejunostomy.
BACKGROUND
In patients with Roux-en-Y hepaticojejunostomy (HJ), endoscopic retrograde cholangiography (ERC) cannot usually be achieved since the anastomosis is not reachable via standard duodenoscope. In this study, we report our experience with ERC using double balloon enteroscope (DBE) (DBE-ERC) in patients with HJ.


METHODS
The DBE-ERC procedures performed since the index case done dated May 3, 2006 have been overviewed.


RESULTS
Fourteen patients underwent the procedure. DBE-ERC was successful in all but one patient, for whom the anastomosis could not be reached (success rate to reach anastomosis: 92.9%). The remaining 13 patients (7 female, 6 male; age 28-61 years, mean 45.3 years) had 20 sessions of DBE-ERC. The cannulation of the bile duct was achieved in all patients. The procedures, such as sphincteroplasty, dilatation, stone extraction and stent placement, were performed. Therapeutic procedures were all successful, except for in a single patient, who had the common bile duct filled with multiple stones and was referred for surgery. Three patients who had anastomotic stenosis treated by stenting are symptom free on follow-up at 3, 9 and 12 months, respectively, after stent removal. Retroperitoneal air was detected in a patient following stricturoplasty, but recovery was attained with medical treatment alone. Mean duration of the procedures was 75 +/- 62 min.


CONCLUSIONS
DBE-ERCP enables us to perform ERC in a group of patients for whom it was impossible previously. Further experience is needed to evaluate its therapeutic efficacy compared with alternative methods.
Parlak
Erkan
E
Departments of Gastroenterology, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey. drerkanparlak@gmail.com
Ciçek
Bahattin
B
Dişibeyaz
Selçuk
S
Cengiz
Cem
C
Yurdakul
Mehmet
M
Akdoğan
Meral
M
Kiliç
Mesut Z Y
MZ
Saşmaz
Nurgül
N
Cumhur
Turhan
T
Sahin
Burhan
B
D000328:Adult; D000713:Anastomosis, Roux-en-Y; D001652:Bile Ducts / Q000293:injuries*; D002404:Catheterization / Q000009:adverse effects; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000295:instrumentation / Q000379:methods*; D002761:Cholangitis / Q000209:etiology; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D020776:Endoscopes, Gastrointestinal; D004867:Equipment Design; D004868:Equipment Failure; D005240:Feasibility Studies; D005260:Female; D005547:Foreign Bodies / Q000601:surgery; D006801:Humans; D007431:Intraoperative Complications / Q000601:surgery*; D007582:Jejunostomy / Q000379:methods*; D008099:Liver / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015607:Stents