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Balloon enteroscope-assisted endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy

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Endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard for diagnosis and intervention in patients with biliopancreatic disorders. However, ERCP in patients with surgically altered anatomy (SAA) is considered more difficult than in patients with normal anatomy. Since the introduction of balloon enteroscopes for patients with small intestine disorders, single-balloon enteroscopes (SBEs) and double-balloon enteroscopes (DBEs) have also been used for biliopancreatic diseases in patients with SAA. Nevertheless, the use of conventional SBEs and DBEs is limited, as a balloon enteroscope has a working length of 200 cm and a narrow working channel with a diameter of 2.8 mm; therefore, few ERCP accessories are available for use. A short-type SBE with a working length of 152 cm and a working channel of 3.2 mm in diameter, and a short-type DBE with a working length of 155 cm and a working channel of 3.2 mm were introduced to solve these difficulties. Favorable outcomes of these devices have recently been reported. Moreover, studies have reported several tips to achieve procedural success and factors affecting procedure failure. Difficult cases necessitate alternative techniques, such as percutaneous transhepatic biliary drainage and endoscopic ultrasound-guided biliary drainage.

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard for diagnosis and intervention in patients with biliopancreatic disorders. However, ERCP in patients with surgically altered anatomy (SAA) is considered more difficult than in patients with normal anatomy. Since the introduction of balloon enteroscopes for patients with small intestine disorders, single-balloon enteroscopes (SBEs) and double-balloon enteroscopes (DBEs) have also been used for biliopancreatic diseases in patients with SAA. Nevertheless, the use of conventional SBEs and DBEs is limited, as a balloon enteroscope has a working length of 200 cm and a narrow working channel with a diameter of 2.8 mm; therefore, few ERCP accessories are available for use. A short-type SBE with a working length of 152 cm and a working channel of 3.2 mm in diameter, and a short-type DBE with a working length of 155 cm and a working channel of 3.2 mm were introduced to solve these difficulties. Favorable outcomes of these devices have recently been reported. Moreover, studies have reported several tips to achieve procedural success and factors affecting procedure failure. Difficult cases necessitate alternative techniques, such as percutaneous transhepatic biliary drainage and endoscopic ultrasound-guided biliary drainage.

참고문헌 (59)

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관련 논문AI추천

Recent advances of endoscopic retrograde cholangiopancreatography in surgically altered anatomy김진홍, Min Jae Yang소화기인터벤션의학회 · International Journal of Gastrointestinal Intervention2021 · 제10권 제3호Single-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy: a technical reviewAkashi Fujita, Kei Sugimoto, Masafumi Mizuide, Rie Shiomi, Shomei Ryozawa, Takahiro Shin, Yuki Tanisaka대한소화기내시경학회 · Clinical Endoscopy2023 · 제56권 제6호Impact of Scope Exchange from a Long Single Balloon Enteroscope to a Gastroscope during Enteroscopy-Assisted Endoscopic Retrograde Cholangiopancreatography in Patients with Surgically Altered Anatomy박창환, Cho Eunae, Cho Seo Yeon, Kim Youngjung거트앤리버 소화기연관학회협의회 · Gut and Liver2022 · 제16권 제2호Single Balloon Enteroscopy-Assisted Endoscopic Retrograde Cholangiopancreatography in Patients Who Underwent a Gastrectomy with Roux-en-Y Anastomosis: Six Cases from a Single Center명승재, 배정호, 변정식, 소재승, 양동훈, 양석균, 이상수, 이서현대한소화기내시경학회 · Clinical Endoscopy2015 · 제48권 제5호Challenges of Endoscopic Management of Pancreaticobiliary Complications in Surgically Altered Gastrointestinal AnatomyEun Young Kim, Tin Moe Wai대한소화기내시경학회 · Clinical Endoscopy2016 · 제49권 제6호Endoscopic Retrograde Cholangiopancreatography in Bilioenteric Anastomosis박은택대한소화기내시경학회 · Clinical Endoscopy2016 · 제49권 제6호

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