Altered anatomy: enteroscopy and ERCP procedure.
Roux-en-Y entero-enteric anastomosis of the small bowel is a commonly used surgical technique. However, it excludes the afferent limb and the biliopancreatic system from conventional endoscopic access. Recent data have shown that device-assisted enteroscopy (DAE) allows endoscopic retrograde cholangiopancreatography (ERCP) in these patients with high success rates. Both Double-balloon, short Double-balloon, Single-balloon and Spiral enteroscopy can be used for DAE-ERCP with comparable success. This review highlights the currently available literature data on DAE-ERCP in patients with Roux-en-Y anastomosis, and discusses the clinical aspects and technical difficulties. Although DAE does increase ERCP efficacy in patients with Roux-en-Y anastomosis, it remains a challenging procedure which is open to further improvement.
Department of Gastroenterology & Hepatology, Antwerp University Hospital, Wilrijkstraat 10, B-2650 Antwerp, Belgium. tom.moreels@uza.be
Tom G
TG
Moreels
D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects / Q000379:methods; D002404:Catheterization / Q000379:methods; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000295:instrumentation / Q000379:methods*; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007421:Intestine, Small / Q000473:pathology; D010535:Laparoscopy