Single-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy: a technical review
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Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy is technically challenging. Forexample, scope insertion, selective cannulation, and intended procedures, such as stone extraction or stent placement, can be difficult. Single-balloon enteroscopy (SBE)-assisted ERCP has been used to effectively and safely address these technical issues in clinical prac-tice. However, the small working channel limits its therapeutic potential. To address this shortcoming, a short-type SBE (short SBE)with a working length of 152 cm and a channel of 3.2 mm diameter has recently been introduced. Short SBE facilitates the use of largeraccessories to complete certain procedures, such as stone extraction or self-expandable metallic stent placement. Despite the develop-ment in the SBE endoscope, various steps have to be overcome to successfully perform such procedure. To improve success, the chal-lenging factors of each procedure must be identified. At the same time, endoscopists need to be mindful of adverse events, such as per-foration, which can arise due to adhesions specific to the surgically altered anatomy. This review discussed technical tips regardingSBE-assisted ERCP in patients with surgically altered anatomy to increase success and reduce the risk of adverse events associated withERCP.
Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy is technically challenging. Forexample, scope insertion, selective cannulation, and intended procedures, such as stone extraction or stent placement, can be difficult. Single-balloon enteroscopy (SBE)-assisted ERCP has been used to effectively and safely address these technical issues in clinical prac-tice. However, the small working channel limits its therapeutic potential. To address this shortcoming, a short-type SBE (short SBE)with a working length of 152 cm and a channel of 3.2 mm diameter has recently been introduced. Short SBE facilitates the use of largeraccessories to complete certain procedures, such as stone extraction or self-expandable metallic stent placement. Despite the develop-ment in the SBE endoscope, various steps have to be overcome to successfully perform such procedure. To improve success, the chal-lenging factors of each procedure must be identified. At the same time, endoscopists need to be mindful of adverse events, such as per-foration, which can arise due to adhesions specific to the surgically altered anatomy. This review discussed technical tips regardingSBE-assisted ERCP in patients with surgically altered anatomy to increase success and reduce the risk of adverse events associated withERCP.
참고문헌 (39)
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