Utility of the Anterior Oblique-Viewing Endoscope and the Double-Balloon Enteroscope for Endoscopic Retrograde Cholangiopancreatography in Patients with Billroth II Gastrectomy

Abstract EN

Background/Purpose.

The difficulties of endoscopic retrograde cholangiopancreatography in patients with Billroth II gastrectomy have been reported.

We evaluated the usefulness of an anterior oblique-viewing endoscope and a double-balloon enteroscope for endoscopic retrograde cholangiopancreatography in such patients.

Methods.

From January 2003 to December 2011, 65 patients with Billroth II gastrectomy were enrolled in this study.

An anterior oblique-viewing endoscope was used for all patients.

From February 2007, a double-balloon enteroscope was used for the failed cases.

The success rate of procedures was compared with those in 20 patients with Billroth II gastrectomy using forward-viewing endoscope or side-viewing endoscope from March 1996 to July 2002 as historical controls.

Results.

In all patients in whom the papilla was reached (60/65), selective cannulation was achieved.

The success rate of selective cannulation and accomplishment of planned procedures in the anterior oblique-viewing endoscope group were both significantly higher than that in the control group (100% versus 70.1%, 100 versus 58.8%, resp.).

A double-balloon enteroscope was used in 2 patients, and the papilla could be reached and the planned procedures completed.

Conclusions.

An anterior oblique-viewing endoscope and double-balloon enteroscope appear to be useful in performing endoscopic retrograde cholangiopancreatography in patients with Billroth II gastrectomy.