title: Double balloon endoscope facilitates endoscopic retrograde cholangiopancreatography in roux-en-y anastomosis patients.
abstract: Endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard for the treatment of patients with pancreaticobiliary disorders, but endoscopic therapy is very difficult to carry out in patients with a Roux-en-Y anastomosis. We herein present the results of ERCP for patients with a Roux-en-Y anastomosis using a double-balloon endoscope. Six patients (six men with a mean age of 69 years) who had undergone prior gastric resection with Roux-en-Y reconstruction were enrolled in the present study and underwent ERCP and associated procedures. ERCP was carried out with a double balloon endoscope, which has one balloon attached to the tip of the endoscope and another attached to the distal end of the soft overtube. In all patients, entering the Y loop was successfully accomplished, and the papilla of Vater was also reached in all cases (100%). Cannulation was successful in four patients (66.7%). The final diagnosis was choledocholithiasis in two patients, biliary fistula in one patient and pancreatic cancer in one patient. A needle-knife precut papillotomy was carried out after placement of a bile duct stent in two patients, and injection of N-butyl-2-cyanoacrylate into a biliary fistula was carried out in one patient. None of the patients suffered from any complications. A double balloon endoscope is therefore considered to be useful for carrying out ERCP and associated procedures in patients with a Roux-en-Y anastomosis.
authors.affiliation: Department of Gastroenterology and Hepatology, Hikari Municipal Yamato General Hospital, Yamaguchi, Japan.
authors.forename: Sayaka
authors.initials: S
authors.lastname: Iwamoto
authors.forename: Shomei
authors.initials: S
authors.lastname: Ryozawa
authors.forename: Hironori
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Kumiko
authors.initials: K
authors.lastname: Taba
authors.forename: Noriko
authors.initials: N
authors.lastname: Ishigaki
authors.forename: Megumi
authors.initials: M
authors.lastname: Harano
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Iwano
authors.forename: Isao
authors.initials: I
authors.lastname: Sakaida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000713:Anastomosis, Roux-en-Y; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods*; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D013270:Stomach / Q000601:surgery; D013274:Stomach Neoplasms / Q000601:surgery