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EXPANDABLE METALLIC STENT‐ASSISTED BILIARY LITHOTRIPSY IN PATIENTS WITH BILLROTH II GASTRECTOMY
Author(s) -
MINAMI ATSUSHI
Publication year - 2003
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1046/j.1443-1661.2003.00215.x
Subject(s) - medicine , major duodenal papilla , balloon dilation , billroth ii , stent , lithotripsy , billroth i , gastrectomy , bile duct , common bile duct , surgery , balloon , gastroenterology , general surgery , cancer
The difficulty in orienting a duodenoscope or sphincterotome in Billroth II gastrectomy patients with an afferent loop is well known to experienced biliary endoscopists. Endoscopic papillary balloon dilation (EPD) can be particularly useful in this group of patients. However, while EPD is relatively simple, lithotripsy afterward is difficult. To address this point, a new technique was developed to gain and preserve access to the common bile duct (CBD). This new technique, expandable metallic stent‐assisted biliary lithotripsy (EMS‐L), utilizes a self‐expandable metallic stent to dilate the major duodenal papilla and preserve access to the CBD. In three patients who had previously undergone a Billroth II gastrectomy, EMS‐L was attempted and was successful. No previous reports of EMS‐L in Billroth II gastrectomy patients are available.