Endoscopic approaches for pancreatobiliary diseases in patients with altered gastrointestinal anatomy. (30th September 2013)

• Record Type: Journal Article
• Authors: Shimatani, Masaaki; Takaoka, Makoto; Matsushita, Mitsunobu; Okazaki, Kazuichi
• Is Part Of: Digestive endoscopy. Volume 26(2014)Supplement 1
• Page Start: 70
• Page End: 78
• Publication Date: 2013-09-30
• Subjects: balloon‐assisted endoscope -- Billroth II gastrectomy -- double balloon endoscope -- endoscopic retrograde cholangiopancreatography (ERCP) -- Roux‐en Y reconstruction; Digestive organs -- Diseases -- Periodicals; Digestive organs -- Diseases -- Diagnosis -- Periodicals; Endoscopy -- Periodicals; Digestive System Diseases -- diagnosis -- Periodicals; Digestive System Diseases -- therapy -- Periodicals; Endoscopy -- Periodicals; 616.3
• DOI: 10.1111/den.12175
• Languages: English
• ISSNs: 0915-5635

Abstract

Abstract : Endoscopic treatment for pancreatobiliary diseases is less invasive than surgery and percutaneous transhepatic biliary drainage is highly beneficial to patients. The endoscopic approach is indicated for an increasing number of patients, including those who have undergone previous gastrointestinal surgery, although these patients face two major challenges. First, the endoscopic approach to the afferent loop, blind end, and the site of choledochojejunostomy is difficult with the use of a conventional endoscope because of the distance from the gastrojejunal anastomosis site, unusual anatomical features of the intestine such as its winding shape, and postoperative adhesion. Second, it is difficult to reach Vater's papilla or the site of choledochojejunostomy andto cannulate selectively into the pancreatic and/or biliary duct. The balloon‐assisted endoscope (BAE), a recently developed technology, can be useful for carrying out endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy. ERCP using the BAE is highly effective and safe in patients with altered gastrointestinal anatomy, especially in patients with Roux‐en‐Y reconstruction.