title: Double-balloon enteroscopy-assisted endoscopic retrograde cholangiography for Roux-en-Y reconstruction patients with papilla of Vater or bilioenteric anastomosis.
abstract: OBJECTIVE
  Roux-en-Y reconstructions can be divided into intact papilla of Vater and bilioenteric anastomosis (BEA) with respect to endoscopic retrograde cholangiography (ERC). Double-balloon enteroscopy-assisted ERC (DBE-ERC) may produce different results between the two populations but lacks studies.
  
  
  METHODS
  Forty-seven patients with Roux-en-Y anastomosis undergoing 73 procedures of DBE-ERC were enrolled between July 2007 and August 2013. There were 14 patients with intact papilla of Vater (group A) and 33 patients with BEA (group B). The effectiveness of DBE-ERC, including data of reaching the blind end, performance of ERC, results of endoscopic therapies, and follow-up were retrospectively analyzed and compared between the two groups.
  
  
  RESULTS
  For reaching the blind end, the success rate was not different between the groups (85.7% vs. 81.8%, p = 0.7), but the mean procedure time was significantly shorter for group A (28 min vs. 52 min, p = 0.01). For ERC, the success rate was not different between the groups (91.7% vs. 96.3%, p = 0.53), but the mean procedure time was significantly longer for group A (28.4 min vs. 4 min, p < 0.001). All endoscopic therapies could be successfully performed in both groups. No group A patients and five (23.8%) group B patients developed recurrent biliary stricture/stones requiring interventions during a mean follow-up period of 26.1 months.
  
  
  CONCLUSIONS
  DBE-ERC was effective for both populations with biliary disorders. Reaching the blind end was more difficult but ERC was easier for patients with BEA in terms of procedure time rather than success rates.
authors.affiliation: a 1 Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine , Taipei, Taiwan.
authors.forename: Yung-Kuan
authors.initials: YK
authors.lastname: Tsou
authors.affiliation: a 1 Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine , Taipei, Taiwan.
authors.forename: Mu-Shien
authors.initials: MS
authors.lastname: Lee
authors.affiliation: b 2 Department of Emergency Medicine, Chang Gung Memorial Hospital , Keelung, Taiwan.|c 3 Clinical Informatics and Medical Statistics Research Center, Chang Gung University , Taoyuan, Taiwan.
authors.forename: Kuan-Fu
authors.initials: KF
authors.lastname: Chen
authors.affiliation: a 1 Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine , Taipei, Taiwan.
authors.forename: Cheng-Hui
authors.initials: CH
authors.lastname: Lin
authors.affiliation: a 1 Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine , Taipei, Taiwan.
authors.forename: Kai-Feng
authors.initials: KF
authors.lastname: Sung
authors.affiliation: b 2 Department of Emergency Medicine, Chang Gung Memorial Hospital , Keelung, Taiwan.
authors.forename: Chin-Chieh
authors.initials: CC
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000713:Anastomosis, Roux-en-Y; D001662:Biliary Tract Surgical Procedures / Q000379:methods*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D058582:Double-Balloon Enteroscopy; D004386:Duodenum / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000000981:diagnostic imaging; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging* / Q000601:surgery; D011183:Postoperative Complications; D012189:Retrospective Studies
keywords: Bilioenteric anastomosis; Roux-en-Y reconstruction; double-balloon enteroscopy; endoscopic retrograde cholangiography; intact papilla of Vater