Open AccessSuccessful endoscopic retrograde cholangiopancreatography using pancreatic guidewire placement for biliary cannulation in a patient with situs inversus and Billroth‐I gastrectomy (with video)
Author(s) -
Tanisaka Yuki,
Ryozawa Shomei,
Sudo Kosuke,
Fujita Akashi,
Mizuide Masafumi,
aka Kouichi,
Tashima Tomoaki
Publication year - 2019
Publication title -
jgh open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.546
H-Index - 8
ISSN - 2397-9070
DOI - 10.1002/jgh3.12163
Subject(s) - medicine , situs inversus , endoscopic retrograde cholangiopancreatography , billroth ii , catheter , surgery , gastrectomy , pancreatic duct , pancreatitis , cancer
We reported a 95‐year‐old man with cholangitis who underwent Billroth‐I gastrectomy. He was diagnosed with situs inversus viscerum and ERCP was performed. A stable field of view could not be secured due to anatomical factors (Billroth‐I gastrectomy) and strong respiratory variations. However, pancreatic duct cannulation was possible. A pancreatic guidewire was placed to achieve selective biliary cannulation. This stabilized the field of view. The catheter was inserted on the right side of the guidewire. Cannulation to the 1 o'clock direction achieved biliary cannulation. Intended procedure was completed safely in the present case.