title: Pitfalls of pancreatobiliary endoscopy after Billroth II gastrectomy.
abstract: OBJECTIVE
  The aim of this retrospective study is the analysis of the success rate of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in our group of patients with Billroth II gastrectomy.
  
  
  METHODS
  The study of the group was carried out during 14 years, i.e. from November 1994 to December 2008. It retrospectively evaluates 120 patients with Billroth II gastrectomy.
  
  
  RESULTS
  A cannulation success rate of 90.8% (109 of 120 patients) was reached in performing ERCP in 120 patients with Billroth II gastrectomy. There were normal ERCP results in 4 patients. ERCP results in the remaining 105 patients were pathological. Endoscopic treatment was started in all of these 105 patients immediately after diagnostic ERCP. Overall, therapeutic ERCP was completely successful in 91 of 105 patients (86.66%) who were originally treated with endoscopy.
  
  
  CONCLUSIONS
  ERCP in patients with Billroth II gastrectomy is much more demanding in contrast with standard procedure due to different postoperative anatomy. ERCP success is determined mainly by great personal experience and skillfulness of the endoscopist. ERCP performed lege artis in patients with Billroth II gastrectomy is a highly effective and safe method where the success rate reached can be almost the same as in a normal anatomical situation.
authors.affiliation: Department of Gastroenterology, St. Anne's University Hospital, Brno, Czech Republic. bohusalav.kianicka@fnusa.cz
authors.forename: Bohuslav
authors.initials: B
authors.lastname: Kianicka
authors.forename: Petr
authors.initials: P
authors.lastname: Dite
authors.forename: Petr
authors.initials: P
authors.lastname: Piskac
mesh_terms: D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D002983:Clinical Competence; D018153:Czech Republic; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D005763:Gastroenterostomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D011237:Predictive Value of Tests; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome