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Surgical Endoscopy

, Volume 24, Issue 2, pp 466–470 | Cite as

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

  • Erkan ParlakEmail author
  • Bahattin Çiçek
  • Selçuk Dişibeyaz
  • Cem Cengiz
  • Mehmet Yurdakul
  • Meral Akdoğan
  • Mesut Z. Y. Kılıç
  • Nurgül Şaşmaz
  • Turhan Cumhur
  • Burhan Şahin
Article

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.

Keywords

Roux-en-Y-hepaticojejunostomy Pancreato bilio < cancer Cholecystectomy ERCP (endoscopic retrograde cholangiopancreatography) Double balloon enteroscopy Diagnostic and therapeutic 

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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Erkan Parlak
    • 1
    Email author
  • Bahattin Çiçek
    • 1
  • Selçuk Dişibeyaz
    • 1
  • Cem Cengiz
    • 1
  • Mehmet Yurdakul
    • 2
  • Meral Akdoğan
    • 1
  • Mesut Z. Y. Kılıç
    • 1
  • Nurgül Şaşmaz
    • 1
  • Turhan Cumhur
    • 2
  • Burhan Şahin
    • 1
  1. 1.Departments of GastroenterologyTürkiye Yüksek İhtisas HospitalAnkaraTurkey
  2. 2.Departments of RadiologyTürkiye Yüksek İhtisas HospitalAnkaraTurkey

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