Experiences of biliary interventions using short double-balloon enteroscopy in patients with Roux-en-Y anastomosis or hepaticojejunostomy.
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.
Tsujino
Takeshi
T
Department of Gastroenterology, Faculty of Medicine, University of Tokyo, Tokyo, Japan. tsujinot-int@h.u-tokyo.ac.jp
Yamada
Atsuo
A
Isayama
Hiroyuki
H
Kogure
Hirofumi
H
Sasahira
Naoki
N
Hirano
Kenji
K
Tada
Minoru
M
Kawabe
Takao
T
Omata
Masao
M
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