Department of Internal Medicine, Dankook University Medical College, Cheonan, Korea
ABSTRACT
Endoscopic retrograde cholangiopancreatography (ERCP) is often unsuccessful in patients with surgically altered gastrointestinal anatomy such as total gastrectony with Roux-en-Y anastomosis because of the long length of afferent limb that makes it difficult to reach the major papilla. In such cases, alternative approaches, using adult or pediatric colonoscopies or conventional forward-viewing upper endoscopy with transparent cap, have been challenged. Recently, methods using double- balloon or single-balloon enteroscopies have been reported. However, these methods can be used limitedly as long length ERCP accessories are not commercially available. We here report a case of successful common bile duct stone removal by single-balloon enteroscopy (SBE)-assisted ERCP with an overtube-assisted technique in patients with surgically altered Roux-en-Y anatomy. Compared with others, conventional length of accessories can be used for therapeutic ERCP in this method. SBE-assisted ERCP with an overtube-assisted technique can be useful salvage technique in patients with surgically altered gastrointestinal anatomy.
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