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- W4251252007 abstract "BackgroundAlthough ERCP is technically challenging in patients with surgically altered anatomy, with the advent of double-balloon enteroscopy (DBE), endoscopic access to the pancreaticobiliary system can be more effectively achieved in such patients, so various therapeutic interventions have become possible.MethodsBetween February 2006 and November 2010, we performed endoscopic pancreaticobiliary interventions in 46 patients (82 sessions) using a short DBE (152 cm in length with a 2.8 mm working channel; EC-450BI5, Fujifilm Medical Co. Ltd., Tokyo, Japan), enabling conventional ERCP accessories. Previous surgeries included pancreaticoduodenectomy (n = 17), Roux-en-Y gastrectomy (n = 10), hepaticojejunostomy (n = 9), Billroth II gastrectomy (n = 6), living donor liver transplantation with hepaticojejunostomy (n = 3), and gastrectomy with jejunal interposition (n = 1). Indication for biliary interventions were bile duct stones (n = 26), anastomotic stricture (n = 16; with bile duct stones [n = 10]), obstructive jaundice (n = 2), cholangitis (n = 1), and pancreatic duct stones (n = 1).ResultsAccess to the papilla or anastomosis was successful in 74 of 82 sessions (90%), with the mean time required to the target orifice being 38 min (4-116 min). Successful cannulation was achieved in 69 of 82 sessions (84%). Pancreaticobiliary interventions were successful in 63 of 82 sessions (77%). Therapeutic procedures included stone extraction (n = 46), balloon dilation of anastomotic stricture (n = 25), biliary plastic stent placement (n = 14), endoscopic naso-biliary drainage (n = 12), papillary balloon dilation (n = 9), papillary large balloon dilation (n = 7), and electrohydraulic lithotripsy (n = 1). The mean overall procedure time was 119 min (20-280 min). Complications occurred in 8 (10%) patients, including retroperitoneal and/or intraperitoneal air (n = 4), cholangitis (n = 2), tension pneumothorax (n = 1), and esophageal hemorrhage (n = 1).ConclusionsPancreaticobiliary interventions using short DBE are effective and safe in patients with surgically altered anatomy. BackgroundAlthough ERCP is technically challenging in patients with surgically altered anatomy, with the advent of double-balloon enteroscopy (DBE), endoscopic access to the pancreaticobiliary system can be more effectively achieved in such patients, so various therapeutic interventions have become possible. Although ERCP is technically challenging in patients with surgically altered anatomy, with the advent of double-balloon enteroscopy (DBE), endoscopic access to the pancreaticobiliary system can be more effectively achieved in such patients, so various therapeutic interventions have become possible. MethodsBetween February 2006 and November 2010, we performed endoscopic pancreaticobiliary interventions in 46 patients (82 sessions) using a short DBE (152 cm in length with a 2.8 mm working channel; EC-450BI5, Fujifilm Medical Co. Ltd., Tokyo, Japan), enabling conventional ERCP accessories. Previous surgeries included pancreaticoduodenectomy (n = 17), Roux-en-Y gastrectomy (n = 10), hepaticojejunostomy (n = 9), Billroth II gastrectomy (n = 6), living donor liver transplantation with hepaticojejunostomy (n = 3), and gastrectomy with jejunal interposition (n = 1). Indication for biliary interventions were bile duct stones (n = 26), anastomotic stricture (n = 16; with bile duct stones [n = 10]), obstructive jaundice (n = 2), cholangitis (n = 1), and pancreatic duct stones (n = 1). Between February 2006 and November 2010, we performed endoscopic pancreaticobiliary interventions in 46 patients (82 sessions) using a short DBE (152 cm in length with a 2.8 mm working channel; EC-450BI5, Fujifilm Medical Co. Ltd., Tokyo, Japan), enabling conventional ERCP accessories. Previous surgeries included pancreaticoduodenectomy (n = 17), Roux-en-Y gastrectomy (n = 10), hepaticojejunostomy (n = 9), Billroth II gastrectomy (n = 6), living donor liver transplantation with hepaticojejunostomy (n = 3), and gastrectomy with jejunal interposition (n = 1). Indication for biliary interventions were bile duct stones (n = 26), anastomotic stricture (n = 16; with bile duct stones [n = 10]), obstructive jaundice (n = 2), cholangitis (n = 1), and pancreatic duct stones (n = 1). ResultsAccess to the papilla or anastomosis was successful in 74 of 82 sessions (90%), with the mean time required to the target orifice being 38 min (4-116 min). Successful cannulation was achieved in 69 of 82 sessions (84%). Pancreaticobiliary interventions were successful in 63 of 82 sessions (77%). Therapeutic procedures included stone extraction (n = 46), balloon dilation of anastomotic stricture (n = 25), biliary plastic stent placement (n = 14), endoscopic naso-biliary drainage (n = 12), papillary balloon dilation (n = 9), papillary large balloon dilation (n = 7), and electrohydraulic lithotripsy (n = 1). The mean overall procedure time was 119 min (20-280 min). Complications occurred in 8 (10%) patients, including retroperitoneal and/or intraperitoneal air (n = 4), cholangitis (n = 2), tension pneumothorax (n = 1), and esophageal hemorrhage (n = 1). Access to the papilla or anastomosis was successful in 74 of 82 sessions (90%), with the mean time required to the target orifice being 38 min (4-116 min). Successful cannulation was achieved in 69 of 82 sessions (84%). Pancreaticobiliary interventions were successful in 63 of 82 sessions (77%). Therapeutic procedures included stone extraction (n = 46), balloon dilation of anastomotic stricture (n = 25), biliary plastic stent placement (n = 14), endoscopic naso-biliary drainage (n = 12), papillary balloon dilation (n = 9), papillary large balloon dilation (n = 7), and electrohydraulic lithotripsy (n = 1). The mean overall procedure time was 119 min (20-280 min). Complications occurred in 8 (10%) patients, including retroperitoneal and/or intraperitoneal air (n = 4), cholangitis (n = 2), tension pneumothorax (n = 1), and esophageal hemorrhage (n = 1). ConclusionsPancreaticobiliary interventions using short DBE are effective and safe in patients with surgically altered anatomy. Pancreaticobiliary interventions using short DBE are effective and safe in patients with surgically altered anatomy." @default.
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- W4251252007 title "Su1456 Therapeutic ERCP Using Short Double-Balloon Enteroscopy in Patients With Surgically Altered Anatomy" @default.
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