title: Tips and tricks of double-balloon endoscopic retrograde cholangiopancreatography (with video).
abstract: Although endoscopic retrograde cholangiopancreatography (ERCP) is technically difficult in patients with altered gastrointestinal tract, double-balloon endoscopy (DBE) allows endoscopic access to pancreato-biliary system in such patients. Balloon dilation of biliary stricture and extraction of bile duct stones, placement of biliary stent in patients with Roux-en-Y or Billroth-II reconstruction, using DBE have been reported. However, two major technical parts are required for double-balloon ERCP (DB-ERCP). One is insertion of DBE and the other is an ERCP-related procedure. The important point of DBE insertion is a sure approach to the afferent limb with Roux-en-Y reconstruction or Braun anastomosis. Short type DBE with working length 152 cm is beneficial for DB-ERCP because it is short enough for most biliary accessory devices. In this paper, we introduce our tips and tricks for successful DB-ERCP.
authors: Department of Gastroenterology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. hatanaka@jichi.ac.jp.
authors: Hisashi
authors: H
authors: Hatanaka
authors: Department of Gastroenterology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors: Tomonori
authors: T
authors: Yano
authors: Department of Gastroenterology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors: Kiichi
authors: K
authors: Tamada
mesh_terms: D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000295:instrumentation*; D002779:Cholestasis / Q000601:surgery*; D004867:Equipment Design; D006801:Humans; D017410:Practice Guidelines as Topic
keywords: Double-balloon ERCP; Double-balloon endoscopy; Endoscopic retrograde cholangiopancreatography; ·Roux-en-Y reconstruction