title: Use of a cap in single-balloon enteroscopy-assisted endoscopic retrograde cholangiography.
abstract: OBJECTIVE
  Cannulation of the native papilla in surgically altered anatomy is difficult in endoscopic retrograde cholangiography (ERC). There are limited data regarding the success of single-balloon enteroscopy-assisted ERC (SBE-ERC) in patients with a native papilla and Roux-en-Y gastric bypass. Use of a plastic cap may assist cannulation in these cases. The aim of the current study was to investigate the use of SBE-ERC with a cap (Cap-SBE-ERC) in patients with surgically altered anatomy referred for ERC.
  
  
  METHODS
  Patients with surgically altered anatomy (hepaticojejunostomy, gastric bypass surgery, and Whipple's surgery) who underwent Cap-SBE-ERC were identified from a prospectively maintained database. Outcomes were diagnostic and procedural success. Patients with a native papilla were compared with those with a biliary-enteric anastomosis.
  
  
  RESULTS
  Among 56 patients with surgically altered anatomy, high rates of diagnostic and procedural success were observed (78.6 % and 71.4 %, respectively). High diagnostic and procedural success rates of 72.7 % and 65.9 %, respectively, were also observed for patients with Roux-en-Y gastric bypass anatomy with a native papilla (n = 44).
  
  
  CONCLUSIONS
  High rates of diagnostic and procedural success were reported for SBE-ERC with the use of a cap, including a large subgroup of patients with Roux-en-Y gastric bypass and a native papilla.
authors.affiliation: Center for Advanced Endoscopy, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Arvind J
authors.initials: AJ
authors.lastname: Trindade
authors.affiliation: Center for Advanced Endoscopy, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Mella
authors.affiliation: Center for Advanced Endoscopy, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Eoin
authors.initials: E
authors.lastname: Slattery
authors.affiliation: Center for Advanced Endoscopy, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Jonah
authors.initials: J
authors.lastname: Cohen
authors.affiliation: Center for Advanced Endoscopy, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Jacob
authors.initials: J
authors.lastname: Dickstein
authors.affiliation: Center for Advanced Endoscopy, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Sagar S
authors.initials: SS
authors.lastname: Garud
authors.affiliation: Center for Advanced Endoscopy, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Ram
authors.initials: R
authors.lastname: Chuttani
authors.affiliation: Center for Advanced Endoscopy, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Pleskow
authors.affiliation: Center for Advanced Endoscopy, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Mandeep S
authors.initials: MS
authors.lastname: Sawhney
authors.affiliation: Center for Advanced Endoscopy, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Tyler M
authors.initials: TM
authors.lastname: Berzin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D002758:Cholangiography / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D016145:Endoscopy, Digestive System / Q000295:instrumentation* / Q000379:methods; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology; D012189:Retrospective Studies