Cap-assisted ERCP in Surgically Altered Anatomy.
- Author:
Eun Seo PARK
1
;
Tae Hoon LEE
;
Sang Heum PARK
;
Gyu Bong KO
;
Bum Suk SON
;
Yun Suk SHIM
;
Sae Hwan LEE
;
Hong Soo KIM
;
Sun Joo KIM
Author Information
1. Department of Internal Medicine, Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea. thlee9@lycos.co.kr
- Publication Type:Original Article
- Keywords:
ERCP;
Cap-assisted ERCP;
Billroth II;
Roux-en-Y anastomosis
- MeSH:
Anastomosis, Roux-en-Y;
Bile Ducts;
Catheterization;
Cholangiopancreatography, Endoscopic Retrograde;
Gastrectomy;
Gastroenterostomy;
Gastroscopes;
Humans;
Intubation
- From:Korean Journal of Gastrointestinal Endoscopy
2010;41(6):344-349
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Endoscopic retrograde cholangiopancreatography (ERCP) is a difficult procedure to perform on patients who have undergone a Billroth II gastrectomy, Whipple's operation or Roux-en-Y gastrobypass surgery. Our study was designed to evaluate the clinical usefulness of cap-assisted ERCP for beginner endoscopists in cases of surgically altered anatomy. METHODS: From April 2008 to March 2010, 16 patients with biliary diseases and who had previously undergone abdominal surgery such as Billroth II gastrectomy or Roux-en-Y operation were analyzed. A single endoscopist performed all the procedures using a cap-assisted gastroscope, after ERCP training. RESULTS: Cap-assisted ERCP was attempted in 24 sessions of 16 patients. Afferent loop intubation and selective bile duct cannulation was successfully achieved in 19 sessions (79.1%). Among the patients who had undergone a Billroth II gastrectomy, 19 out of 20 sessions were successfully conducted. Only 4 patients who had undergone a previous Roux-en-Y operation failed afferent loop intubation. Duodenal free wall perforation developed in one case. There were no cases of mortality. CONCLUSIONS: Therapeutic cap-assisted ERCP was useful in patients who had previously undergone a Billroth II gastrectomy and this may be helpful for inexperienced endoscopists.
