title: ERCP for patients who have undergone Billroth II gastroenterostomy and Braun anastomosis.
abstract: Endoscopic retrograde cholangiopancreatography (ERCP) is efficacious in patients who have undergone Billroth II gastroenterostomies, but the success rate decreases in patients who also have experienced Braun anastomoses. There are currently no reports describing the preferred enterography route for cannulation in these patients. We first review the patient's previous surgery records, which most often indicate that the efferent loop is at the greater curvature of the stomach. We recommend extending the duodenoscope along the greater curvature of the stomach and then advancing it through the "lower entrance" at the site of the gastrojejunal anastomosis, along the efferent loop, and through the "middle entrance" at the site of the Braun anastomosis to reach the papilla of Vater. Ten patients who had each undergone Billroth II gastroenterostomy and Braun anastomosis between January 2009 and December 2011 were included in our study. The overall success rate of enterography was 90% for the patients who had undergone Billroth II gastroenterostomy and Braun anastomosis, and the therapeutic success rate was 80%. We believe that this enterography route for ERCP is optimal for a patient who has had Billroth II gastroenterostomy and Braun anastomosis and helps to increase the success rate of the procedure.
authors.affiliation: Wen-Guang Wu, Jun Gu, Wen-Jie Zhang, Ming-Ning Zhao, Ming Zhuang, Ying-Bin Liu, Xue-Feng Wang, Laboratory of General Surgery and Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai 200092, China.
authors.forename: Wen-Guang
authors.initials: WG
authors.lastname: Wu
authors.affiliation: Wen-Guang Wu, Jun Gu, Wen-Jie Zhang, Ming-Ning Zhao, Ming Zhuang, Ying-Bin Liu, Xue-Feng Wang, Laboratory of General Surgery and Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai 200092, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Gu
authors.affiliation: Wen-Guang Wu, Jun Gu, Wen-Jie Zhang, Ming-Ning Zhao, Ming Zhuang, Ying-Bin Liu, Xue-Feng Wang, Laboratory of General Surgery and Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai 200092, China.
authors.forename: Wen-Jie
authors.initials: WJ
authors.lastname: Zhang
authors.affiliation: Wen-Guang Wu, Jun Gu, Wen-Jie Zhang, Ming-Ning Zhao, Ming Zhuang, Ying-Bin Liu, Xue-Feng Wang, Laboratory of General Surgery and Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai 200092, China.
authors.forename: Ming-Ning
authors.initials: MN
authors.lastname: Zhao
authors.affiliation: Wen-Guang Wu, Jun Gu, Wen-Jie Zhang, Ming-Ning Zhao, Ming Zhuang, Ying-Bin Liu, Xue-Feng Wang, Laboratory of General Surgery and Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai 200092, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Zhuang
authors.affiliation: Wen-Guang Wu, Jun Gu, Wen-Jie Zhang, Ming-Ning Zhao, Ming Zhuang, Ying-Bin Liu, Xue-Feng Wang, Laboratory of General Surgery and Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai 200092, China.
authors.forename: Yi-Jing
authors.initials: YJ
authors.lastname: Tao
authors.affiliation: Wen-Guang Wu, Jun Gu, Wen-Jie Zhang, Ming-Ning Zhao, Ming Zhuang, Ying-Bin Liu, Xue-Feng Wang, Laboratory of General Surgery and Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai 200092, China.
authors.forename: Ying-Bin
authors.initials: YB
authors.lastname: Liu
authors.affiliation: Wen-Guang Wu, Jun Gu, Wen-Jie Zhang, Ming-Ning Zhao, Ming Zhuang, Ying-Bin Liu, Xue-Feng Wang, Laboratory of General Surgery and Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai 200092, China.
authors.forename: Xue-Feng
authors.initials: XF
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000295:instrumentation / Q000379:methods*; D020698:Duodenoscopes; D005260:Female; D005763:Gastroenterostomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: Billroth II; Braun anastomosis; Endoscopic retrograde cholangiopancreatography; Gastroenterostomy; Optimal enterography route