title: Endoscopic retrograde cholangiography by double balloon enteroscopy in patients with Roux-en-Y hepaticojejunostomy.
abstract: 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.
authors: Departments of Gastroenterology, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey. drerkanparlak@gmail.com
authors: Erkan
authors: E
authors: Parlak
authors: Bahattin
authors: B
authors: Ciçek
authors: Selçuk
authors: S
authors: Dişibeyaz
authors: Cem
authors: C
authors: Cengiz
authors: Mehmet
authors: M
authors: Yurdakul
authors: Meral
authors: M
authors: Akdoğan
authors: Mesut Z Y
authors: MZ
authors: Kiliç
authors: Nurgül
authors: N
authors: Saşmaz
authors: Turhan
authors: T
authors: Cumhur
authors: Burhan
authors: B
authors: Sahin
mesh_terms: 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