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Gastrointest Endosc. 2007 Nov;66(5):1038-41.

Double-balloon ERCP in patients who have undergone Roux-en-Y surgery: a case series.

Author information

1
Department of Gastroenterology, Baylor University Medical Center, Dallas, TX 75246, USA.

Abstract

BACKGROUND:

ERCP is technically challenging in patients who have had a long-limb Roux-en-Y surgical procedure. The recent introduction of the double-balloon endoscope permits the examination of a much longer segment of the small bowel compared with a standard endoscope and may be used to perform ERCP in these patients.

OBJECTIVE:

To report successful use of double-balloon ERCP in patients who have had a Roux-en-Y surgical procedure.

PATIENTS:

Fourteen patients with a history of either Roux-en-Y gastric bypass weight-reduction surgery or Roux-en-Y pancreatobiliary surgery required diagnostic and/or therapeutic pancreatobiliary intervention.

DESIGN:

Case report.

INTERVENTION:

Double-balloon ERCP.

RESULTS:

Fourteen patients underwent a total of 20 ERCPs with the double-balloon endoscopy system. The ampulla was successfully reached in 85% of total cases (100% of patients who have had Roux-en-Y weight reduction surgery), with adequate cannulation of either the biliary or pancreatic duct in 80% (88% of patients for weight reduction). Therapeutic intervention, including stone removal, pancreatobiliary-duct dilation, sphincterotomy, stent placement, and removal of previously placed stents, was performed successfully in 6 cases. The mean age was 47 years old. The mean (+/- standard deviation) total duration of the procedure was 99 +/- 48 minutes. There were no immediate or short-term complications.

CONCLUSIONS:

The double-balloon endoscopy system permits diagnostic and therapeutic ERCP in patients who have had long-limb surgical procedures. Our experience demonstrated that this procedure is well tolerated, safe, and has a high success rate.

PMID:
17963892
DOI:
10.1016/j.gie.2007.06.056
[Indexed for MEDLINE]

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