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Endoscopic bile duct and/or pancreatic duct cannulation technique for patients with surgically altered gastrointestinal anatomy
Author(s) -
Okabe Yoshinobu,
Ishida Yusuke,
Kuraoka Kei,
Ushijima Tomoyuki,
Tsuruta Osamu
Publication year - 2014
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 - 10.1111/den.12274
Subject(s) - medicine , pancreatic duct , bile duct , endoscopic retrograde cholangiopancreatography , anastomosis , duct (anatomy) , general surgery , surgery , pancreatitis
There are two major hurdles to carrying out endoscopic retrograde cholangiopancreatography ( ERCP ) in patients with altered gastrointestinal anatomy ( B illroth II gastrectomy [ B ‐ II ], R oux‐en‐ Y anastomosis [ R ‐ Y ] etc.), post‐pancreatoduodenectomy or post‐choledochojejunostomy. These are: (i) the endoscopic approach to the afferent loop, blind end, and the site of bilio‐pancreatic anastomosis; and (ii) bile duct and/or pancreatic duct cannulation. Balloon‐assisted enteroscopy ( BAE ) became available in recent years and is now being actively used to overcome the first hurdle and, at least, the success rate has improved. However, room for improvement still remains in regards to the second hurdle (i.e. the success rate of cannulation of the bile duct and/or pancreatic duct), and there has been a desire for the development of dedicated devices ( ERCP catheters, hoods etc.) and for improvement in the functionality of the enteroscopes etc. In the present review, we explain the basic procedure for bile duct and/or pancreatic duct cannulation with conventional endoscopes and BAE , and modifications of the basic procedure.