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Double‐balloon enteroscopy for choledochojejunal anastomotic stenosis after hepato‐biliary‐pancreatic operation
Author(s) -
Sakakihara Ichiro,
Kato Hironari,
Muro Shinichiro,
Noma Yasuhiro,
Yamamoto Naoki,
Harada Ryo,
Horiguchi Shigeru,
Tsutsumi Koichiro,
Okada Hiroyuki,
Yamamoto Kazuhide,
Sadamori Hiroshi,
Yagi Takahito
Publication year - 2015
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.12332
Subject(s) - medicine , anastomosis , balloon dilation , stenosis , restenosis , stent , enteroscopy , radiology , surgery , balloon , endoscopy
Background and Aim There have been few reports on the success rate of balloon dilation and stent deployment using endoscopic retrograde cholangiopancreatography by double‐balloon enteroscopy ( DBE‐ERCP ) or on the follow‐up period after stent removal in patients with a reconstructed digestive tract and stenosis of choledochojejunal anastomosis. The present study was designed to evaluate the usefulness of DBE‐ERCP in patients with a reconstructed digestive tract and stenosis of choledochojejunal anastomosis. Methods Forty‐four patients with stenosis of choledochojejunal anastomosis underwent DBE‐ERCP at O kayama U niversity H ospital between A pril 2008 and J anuary 2012 (107 procedures). Rates of reaching choledochojejunal anastomosis, stent deployment, and restenosis after stent removal were retrospectively evaluated. Results Insertion of DBE into the choledochojejunal anastomotic site succeeded in 38 of 44 patients (86.4%), and anastomotic dilation and stent deployment succeeded in 36 of 44 patients (81.8%). In 32 of 44 patients (72.7%), their anastomotic stenoses were improved, and they achieved stent removal. After stent removal, restenosis of choledochojejunal anastomosis was detected in seven of 32 patients; however, the resolution of restenosis was achieved in all seven of those patients. Conclusion Dilation of choledochojejunal anastomosis combined with stent deployment using DBE‐ERCP seems to be a viable first‐line treatment for patients with stenosis of choledochojejunal anastomosis.