Usefulness of Forward-Viewing Endoscope for Endoscopic Retrograde Cholangiopancreatography in Patients with Billroth II Gastrectomy.
- Author:
Jong Won BYUN
1
;
Jae Woo KIM
;
Se Yong SUNG
;
Ho Yeon JUNG
;
Hyo Keun JEON
;
Hong Jun PARK
;
Moon Young KIM
;
Hyun Soo KIM
;
Soon Koo BAIK
Author Information
1. Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea. jawkim96@yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Billroth II gastrectomy;
Endoscopic retrograde cholangiopancreatography;
Forward-viewing endoscope
- MeSH:
Catheterization;
Catheters;
Cholangiopancreatography, Endoscopic Retrograde;
Common Bile Duct;
Endoscopes;
Female;
Gastrectomy;
Gastroenterostomy;
Humans;
Male;
Sphincterotomy, Endoscopic
- From:Clinical Endoscopy
2012;45(4):397-403
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Patients undergoing Billroth II (B II) gastrectomy are at higher risk of perforation during endoscopic retrograde cholangiopancreatography (ERCP). We assessed the success rate and safety of forward-viewing endoscopic biliary intervention in patients with B II gastrectomy. METHODS: A total of 2,280 ERCP procedures were performed in our institution between October 2008 and June 2011. Of these, forward-viewing endoscopic biliary intervention was performed in 46 patients (38 men and 8 women with B II gastrectomy). Wire-guided selective cannulations of the common bile duct using a standard catheter and guide wire were performed in all patients. RESULTS: The success rate of afferent loop entrance was 42 out of 46 patients (91.3%) and of biliary cannulation after the approach of the papilla was 42 out of 42 patients (100%). No serious complications were encountered, except for one case of small perforation due to endoscopic sphincterotomy site injury. CONCLUSIONS: When a biliary endoscopist has less experience and patient volume is low, ERCP with a forward-viewing endoscope is preferred because of its ease and safety in all patients with prior B II gastrectomies. Also, forward-viewing endoscope can be used to improve the success rate of biliary intervention in B II patients.
