Daniel S Emmett1, Damien B Mallat. 1. Department of Gastroenterology, Baylor University Medical Center, Dallas, TX 75246, USA.
Abstract
BACKGROUND: ERCP is technically challenging in patients who have had a long-limb Roux-en-Y surgical procedure. The recent introduction of the double-balloon endoscope permits the examination of a much longer segment of the small bowel compared with a standard endoscope and may be used to perform ERCP in these patients. OBJECTIVE: To report successful use of double-balloon ERCP in patients who have had a Roux-en-Y surgical procedure. PATIENTS: Fourteen patients with a history of either Roux-en-Y gastric bypass weight-reduction surgery or Roux-en-Y pancreatobiliary surgery required diagnostic and/or therapeutic pancreatobiliary intervention. DESIGN: Case report. INTERVENTION: Double-balloon ERCP. RESULTS: Fourteen patients underwent a total of 20 ERCPs with the double-balloon endoscopy system. The ampulla was successfully reached in 85% of total cases (100% of patients who have had Roux-en-Y weight reduction surgery), with adequate cannulation of either the biliary or pancreatic duct in 80% (88% of patients for weight reduction). Therapeutic intervention, including stone removal, pancreatobiliary-duct dilation, sphincterotomy, stent placement, and removal of previously placed stents, was performed successfully in 6 cases. The mean age was 47 years old. The mean (+/- standard deviation) total duration of the procedure was 99 +/- 48 minutes. There were no immediate or short-term complications. CONCLUSIONS: The double-balloon endoscopy system permits diagnostic and therapeutic ERCP in patients who have had long-limb surgical procedures. Our experience demonstrated that this procedure is well tolerated, safe, and has a high success rate.
BACKGROUND: ERCP is technically challenging in patients who have had a long-limb Roux-en-Y surgical procedure. The recent introduction of the double-balloon endoscope permits the examination of a much longer segment of the small bowel compared with a standard endoscope and may be used to perform ERCP in these patients. OBJECTIVE: To report successful use of double-balloon ERCP in patients who have had a Roux-en-Y surgical procedure. PATIENTS: Fourteen patients with a history of either Roux-en-Y gastric bypass weight-reduction surgery or Roux-en-Y pancreatobiliary surgery required diagnostic and/or therapeutic pancreatobiliary intervention. DESIGN: Case report. INTERVENTION: Double-balloon ERCP. RESULTS: Fourteen patients underwent a total of 20 ERCPs with the double-balloon endoscopy system. The ampulla was successfully reached in 85% of total cases (100% of patients who have had Roux-en-Y weight reduction surgery), with adequate cannulation of either the biliary or pancreatic duct in 80% (88% of patients for weight reduction). Therapeutic intervention, including stone removal, pancreatobiliary-duct dilation, sphincterotomy, stent placement, and removal of previously placed stents, was performed successfully in 6 cases. The mean age was 47 years old. The mean (+/- standard deviation) total duration of the procedure was 99 +/- 48 minutes. There were no immediate or short-term complications. CONCLUSIONS: The double-balloon endoscopy system permits diagnostic and therapeutic ERCP in patients who have had long-limb surgical procedures. Our experience demonstrated that this procedure is well tolerated, safe, and has a high success rate.
Authors: Martin Raithel; Harald Dormann; Andreas Naegel; Frank Boxberger; Eckhart G Hahn; Markus F Neurath; Juergen Maiss Journal: World J Gastroenterol Date: 2011-05-14 Impact factor: 5.742
Authors: Majed El Zouhairi; James B Watson; Svetang V Desai; David K Swartz; Alejandra Castillo-Roth; Mahfuzul Haque; Paul S Jowell; Malcolm S Branch; Rebecca A Burbridge Journal: World J Gastrointest Endosc Date: 2015-03-16