title: Impact of instrument channel diameter on therapeutic endoscopic retrograde cholangiography using balloon-assisted enteroscopy.
abstract: OBJECTIVE
  In therapeutic endoscopic retrograde cholangiography (ERC) using a balloon-assisted enteroscope, each instrument insertion requires a long time, which prolongs the duration of the procedure. We conducted a retrospective single-center study to compare instrument insertability of a double-balloon enteroscope (DBE) with a 2.8-mm instrument channel diameter and a prototype short single-balloon enteroscope (SBE) with a 3.2-mm instrument channel diameter.
  
  
  METHODS
  We used a stop-watch to measure instrument insertion time from the instrument channel port to the tip of the enteroscope when balloon-assisted ERC was done. The instruments were divided into two groups (outer diameter larger or smaller than 2 mm). Lengths from the instrument channel port to the tip of the DBE (EI-530B; FUJIFILM, Tokyo, Japan) and the prototype SBE (SIF-Y0004-V01; Olympus Medical Systems, Tokyo, Japan) were identical (1680 mm). ERC using DBE was carried out in four cases, as was ERC using SBE.
  
  
  RESULTS
  There was a significant time difference (P= 0.001) when using instruments whose outer diameters were >2 mm (53.5 ± 19.0 s in DBE vs 28.4 ± 8.4 s in SBE).
  
  
  CONCLUSIONS
  The prototype SBE with a 3.2-mm channel demonstrated not only that many types of instrument can be used, but also that the time required to insert instruments may be shorter than that with DBE with a 2.8-mm channel.
authors.affiliation: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kawashima
authors.forename: Masanao
authors.initials: M
authors.lastname: Nakamura
authors.forename: Eizaburo
authors.initials: E
authors.lastname: Ohno
authors.forename: Hidemi
authors.initials: H
authors.lastname: Goto
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Hirooka
mesh_terms: D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000295:instrumentation* / Q000379:methods; D015331:Cohort Studies; D058582:Double-Balloon Enteroscopy / Q000295:instrumentation* / Q000379:methods; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D007564:Japan; D008297:Male; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
keywords: balloon-assisted endoscopic retrograde cholangiopancreatography (ERCP); double-balloon enteroscopy; single-balloon enteroscopy; therapeutic ERCP