TY - JOUR
T1 - Double balloon endoscopy increases the ercp success rate in patients with a history of billroth II gastrectomy
AU - Lin, Cheng Hui
AU - Tang, Jui Hsiang
AU - Cheng, Chi Liang
AU - Tsou, Yung Kuan
AU - Cheng, Hao Tsai
AU - Lee, Mu Hsien
AU - Sung, Kai Feng
AU - Lee, Ching Song
AU - Liu, Nai Jen
PY - 2010/9/28
Y1 - 2010/9/28
N2 - AIM: To evaluate the effect of double balloon endoscope (DBE) on the endoscopic retrograde cholangiopancreatography (ERCP) success rate in patients with a history of Billroth II (B II) gastrectomy. METHODS: From April 2006 to March 2007, 32 patients with a B II gastrectomy underwent 34 ERCP attempts. In all cases, the ERCP procedures were started using a duodenoscope. If intubation of the afferent loop or reaching the papilla failed, we changed to DBE for the ERCP procedure (DBE-ERCP). We assessed the success rate of afferent loop intubation, reaching the major papilla, selective cannulation, possibility of therapeutic approaches, procedure-related complications, and the overall success rate. RESULTS: Among the 32 patients with a history of B II gastrectomy, the duodenoscope was successfully passed up to the papilla in 22 patients (69%), and cannulation was successfully performed in 20 patients (63%). Six patients (2 with failure in afferent loop intubation and 4 with failure in reaching the papilla) underwent DBEERCP. The DBE reached the papilla in all the 6 patients (100%) and selective cannulation was successful in 5 patients (83%). Four patients (67%) who had common bile duct stones were successfully treated. One patient underwent diagnostic ERCP only and the other one, in whom selective cannulation failed, was diagnosed with papilla cancer proven by biopsy. There were no complications related to the DBE. The overall ERCP success rate increased to 88% (28/32). CONCLUSION: The overall ERCP success rate increases with DBE in patients with a previous B II gastrectomy.
AB - AIM: To evaluate the effect of double balloon endoscope (DBE) on the endoscopic retrograde cholangiopancreatography (ERCP) success rate in patients with a history of Billroth II (B II) gastrectomy. METHODS: From April 2006 to March 2007, 32 patients with a B II gastrectomy underwent 34 ERCP attempts. In all cases, the ERCP procedures were started using a duodenoscope. If intubation of the afferent loop or reaching the papilla failed, we changed to DBE for the ERCP procedure (DBE-ERCP). We assessed the success rate of afferent loop intubation, reaching the major papilla, selective cannulation, possibility of therapeutic approaches, procedure-related complications, and the overall success rate. RESULTS: Among the 32 patients with a history of B II gastrectomy, the duodenoscope was successfully passed up to the papilla in 22 patients (69%), and cannulation was successfully performed in 20 patients (63%). Six patients (2 with failure in afferent loop intubation and 4 with failure in reaching the papilla) underwent DBEERCP. The DBE reached the papilla in all the 6 patients (100%) and selective cannulation was successful in 5 patients (83%). Four patients (67%) who had common bile duct stones were successfully treated. One patient underwent diagnostic ERCP only and the other one, in whom selective cannulation failed, was diagnosed with papilla cancer proven by biopsy. There were no complications related to the DBE. The overall ERCP success rate increased to 88% (28/32). CONCLUSION: The overall ERCP success rate increases with DBE in patients with a previous B II gastrectomy.
KW - Billroth ii gastrectomy
KW - Double balloon endoscopy
KW - Endoscopic retrograde cholangiopancreatography
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U2 - 10.3748/wjg.v16.i36.4594
DO - 10.3748/wjg.v16.i36.4594
M3 - Article
C2 - 20857532
AN - SCOPUS:77957559710
SN - 1007-9327
VL - 16
SP - 4594
EP - 4598
JO - World Journal of Gastroenterology
JF - World Journal of Gastroenterology
IS - 36
ER -