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Endoscopic retrograde cholangiography by double balloon enteroscopy in patients with Roux-en-Y hepaticojejunostomy

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Abstract

Background

In patients with Roux-en-Y hepaticojejunostomy (HJ), endoscopic retrograde cholangiography (ERC) cannot usually be achieved since the anastomosis is not reachable via standard duodenoscope. In this study, we report our experience with ERC using double balloon enteroscope (DBE) (DBE-ERC) in patients with HJ.

Methods

The DBE-ERC procedures performed since the index case done dated May 3, 2006 have been overviewed.

Results

Fourteen patients underwent the procedure. DBE-ERC was successful in all but one patient, for whom the anastomosis could not be reached (success rate to reach anastomosis: 92.9%). The remaining 13 patients (7 female, 6 male; age 28–61 years, mean 45.3 years) had 20 sessions of DBE-ERC. The cannulation of the bile duct was achieved in all patients. The procedures, such as sphincteroplasty, dilatation, stone extraction and stent placement, were performed. Therapeutic procedures were all successful, except for in a single patient, who had the common bile duct filled with multiple stones and was referred for surgery. Three patients who had anastomotic stenosis treated by stenting are symptom free on follow-up at 3, 9 and 12 months, respectively, after stent removal. Retroperitoneal air was detected in a patient following stricturoplasty, but recovery was attained with medical treatment alone. Mean duration of the procedures was 75 ± 62 min.

Conclusion

DBE-ERCP enables us to perform ERC in a group of patients for whom it was impossible previously. Further experience is needed to evaluate its therapeutic efficacy compared with alternative methods.

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Authors and Affiliations

  1. Departments of Gastroenterology, Türkiye Yüksek İhtisas Hospital, Kızılay, 06100, Ankara, Turkey

    Erkan Parlak, Bahattin Çiçek, Selçuk Dişibeyaz, Cem Cengiz, Meral Akdoğan, Mesut Z. Y. Kılıç, Nurgül Şaşmaz & Burhan Şahin

  2. Departments of Radiology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey

    Mehmet Yurdakul & Turhan Cumhur

Authors
  1. Erkan Parlak
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  2. Bahattin Çiçek
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  3. Selçuk Dişibeyaz
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  4. Cem Cengiz
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  5. Mehmet Yurdakul
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  6. Meral Akdoğan
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  7. Mesut Z. Y. Kılıç
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  8. Nurgül Şaşmaz
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  9. Turhan Cumhur
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  10. Burhan Şahin
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Correspondence to Erkan Parlak.

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Parlak, E., Çiçek, B., Dişibeyaz, S. et al. Endoscopic retrograde cholangiography by double balloon enteroscopy in patients with Roux-en-Y hepaticojejunostomy. Surg Endosc 24, 466–470 (2010). https://doi.org/10.1007/s00464-009-0591-3

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  • DOI: https://doi.org/10.1007/s00464-009-0591-3

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