Direct cholangioscopy combined with double-balloon enteroscope-assisted endoscopic retrograde cholangiopancreatography
| Autor: | Takayuki Motoyoshi, Makoto Nishikata, Koji Takai, Toshikazu Yoshikawa, Shogo Matsuda, Tatsuya Koshitani, Hiroyuki Shintani, Toshihiko Kirishima, Yasuhide Yamashita, Naomi Yoshinami |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Gastric Bypass Case Report Balloon digestive system Cholestasis Double-balloon enteroscopy Medicine Humans Aged Billroth II Aged 80 and over Cholangiopancreatography Endoscopic Retrograde Double-Balloon Enteroscopy Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test business.industry Bile duct Gastroenterology Anastomosis Roux-en-Y General Medicine medicine.disease Angioscopy Major duodenal papilla Endoscopes Gastrointestinal Biliary Tract Surgical Procedures medicine.anatomical_structure Choledocholithiasis Treatment Outcome Radiology business |
| Popis: | Double-balloon enteroscope (DBE)-assisted endoscopic retrograde cholangiopancreatography (ERCP) is an effective endoscopic approach for pancreatobiliary disorders in patients with altered gastrointestinal anatomy. Endoscopic interventions via DBE in these postoperative settings remain difficult because of the lack of an elevator and the use of extra-long ERCP accessories. Here, we report the usefulness of direct cholangioscopy with an ultra-slim gastroscope during DBE-assisted ERCP. Three patients with choledocholithiasis in postoperative settings (two patients after Billroth II gastrojejunostomy and one patient after Roux-en-Y gastrojejunostomy) were treated. DBE was used to gain access to the papilla under carbon dioxide insufflation, and endoscopic sphincterotomy was performed with a conventional sphincterotome. For direct cholangioscopy, the enteroscope was exchanged for an ultra-slim gastroscope through an incision in the overtube, which was inserted directly into the bile duct. Direct cholangioscopy was used to extract retained bile duct stones in two cases and to confirm the complete clearance of stones in one case. Bile duct stones were eliminated with a 5-Fr basket catheter under direct visual control. No adverse events were noted in any of the three cases. Direct cholangioscopy with an ultra-slim gastroscope facilitates subsequent treatment within the bile duct. This procedure represents another potential option during DBE-assisted ERCP. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|