title: Single-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography for treatment of cholangitis in a patient with a Kasai portoenterostomy.
abstract: Primary therapy for biliary atresia is a surgical hepatoportoenterostomy (Kasai procedure), which has been shown to reduce mortality, but is frequently complicated by ascending cholangitis and the development of biliary cirrhosis. Previously reported therapy for recurrent cholangitis caused by biliary obstruction has included surgical revision and percutaneous biliary drainage, but endoscopic retrograde cholangiopancreatography has not been previously described. Here, we report a patient with recurrent cholangitis after a Kasai procedure and an anastomotic stricture successfully treated with single-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography. This novel technique could be considered in patients with this common complication of the Kasai procedure and may impact long-term outcomes in this patient population.
authors.affiliation: Department of Medicine, Division of Gastroenterology and Hepatology, University of North Carolina, Campus Box 7080, Chapel Hill, NC 27599-7080, USA. eorman@unch.unc.edu
authors.forename: Eric S
authors.initials: ES
authors.lastname: Orman
authors.forename: C Brock
authors.initials: CB
authors.lastname: Miller
authors.forename: Ian S
authors.initials: IS
authors.lastname: Grimm
authors.forename: A Sidney
authors.initials: AS
authors.lastname: Barritt
mesh_terms: D001656:Biliary Atresia / Q000150:complications / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000295:instrumentation / Q000379:methods*; D002761:Cholangitis / Q000209:etiology / Q000601:surgery*; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D016099:Endoscopy, Gastrointestinal / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D011171:Portoenterostomy, Hepatic; D011183:Postoperative Complications / Q000601:surgery*; D012008:Recurrence; D055815:Young Adult