title: Endoscopic Retrograde Cholangiopancreatography in Surgically Altered Anatomy.
abstract: ERCP in surgically altered anatomy requires the endoscopist to fully understand the procedural goals and the reconstructed anatomy before proceeding. Altered anatomy presents a variety of challenges unique to enteroscopy, and others related to accessing the biliary or pancreatic duct from unusual orientations. Both side-viewing and forward-viewing endoscopes, as well as single and double balloon techniques, are available for ERCP in these settings. Endoscope selection largely depends on the anatomy and length of reconstructed intestinal limbs. Endoscopist experience with performing ERCP in surgically altered anatomy is the most important factor for determining outcomes and success rates.
authors.affiliation: Division of Gastroenterology, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: Victoria
authors.initials: V
authors.lastname: Gómez
authors.affiliation: Division of Gastroenterology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. Electronic address: Petersen.bret@mayo.edu.
authors.forename: Bret T
authors.initials: BT
authors.lastname: Petersen
mesh_terms: D001659:Biliary Tract / Q000473:pathology*; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D019723:Endoscopes; D015390:Gastric Bypass / Q000009:adverse effects; D006801:Humans; D010183:Pancreatic Ducts / Q000473:pathology* / Q000601:surgery; D019738:Surgically-Created Structures / Q000009:adverse effects / Q000473:pathology*
keywords: Biliopancreatic limb; Endoscopic retrograde cholangiopancreatography; Enteroscopy; Gastrojejunostomy; Roux-en-Y reconstruction; Surgically altered bowel anatomy