title: Experiences of biliary interventions using short double-balloon enteroscopy in patients with Roux-en-Y anastomosis or hepaticojejunostomy.
abstract: BACKGROUND
  The efficacy of double-balloon enteroscopy (DBE) for biliary interventions has been shown in patients with surgical anatomy. However, the use of available endoscopic retrograde cholangiography accessories during this procedure is limited because of the length of the conventional instrument (200 cm). The aim of this study was to evaluate the feasibility of short DBE for managing biliary disorders in patients with a Roux-en-Y gastrectomy or hepaticojejunostomy (HJ).
  
  
  METHODS
  Using a short enteroscope (152 cm) and commercially available endoscopic retrograde cholangiography accessories, biliary interventions were performed in six patients with Roux-en-Y reconstruction or HJ anastomosis.
  
  
  RESULTS
  A total of 12 biliary interventions were performed; balloon dilations of the HJ anastomosis or intrahepatic ducts (four patients), nasobiliary drainages (three patients), bile duct stone removal after endoscopic papillary large balloon dilation with or without small sphincterotomy (two patients), and a biliary stent placement (one patient). One patient showed retroperitoneal air following endoscopic papillary large balloon dilation, but recovered conservatively.
  
  
  CONCLUSIONS
  Biliary interventions via DBE using a short enteroscope are feasible in patients with surgical anatomy.
authors.affiliation: Department of Gastroenterology, Faculty of Medicine, University of Tokyo, Tokyo, Japan. tsujinot-int@h.u-tokyo.ac.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tsujino
authors.forename: Atsuo
authors.initials: A
authors.lastname: Yamada
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Isayama
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kogure
authors.forename: Naoki
authors.initials: N
authors.lastname: Sasahira
authors.forename: Kenji
authors.initials: K
authors.lastname: Hirano
authors.forename: Minoru
authors.initials: M
authors.lastname: Tada
authors.forename: Takao
authors.initials: T
authors.lastname: Kawabe
authors.forename: Masao
authors.initials: M
authors.lastname: Omata
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000713:Anastomosis, Roux-en-Y; D000714:Anastomosis, Surgical; D001649:Bile Duct Diseases / Q000628:therapy*; D002404:Catheterization / Q000295:instrumentation*; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006500:Hepatic Duct, Common / Q000601:surgery*; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery; D016896:Treatment Outcome