Double balloon endoscopy increases the ercp success rate in patients with a history of billroth II gastrectomy

Cheng Hui Lin, Jui Hsiang Tang, Chi Liang Cheng, Yung Kuan Tsou, Hao Tsai Cheng, Mu Hsien Lee, Kai Feng Sung, Ching Song Lee, Nai Jen Liu

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)4594-4598
Number of pages5
JournalWorld Journal of Gastroenterology
Issue number36
Publication statusPublished - Sept 28 2010
Externally publishedYes


  • Billroth ii gastrectomy
  • Double balloon endoscopy
  • Endoscopic retrograde cholangiopancreatography

ASJC Scopus subject areas

  • Gastroenterology


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