Case Report
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Dec 21, 2012; 18(47): 7109-7112
Published online Dec 21, 2012. doi: 10.3748/wjg.v18.i47.7109
Retrieval-balloon-assisted enterography in post-pancreaticoduodenectomy endoscopic retrograde cholangiopancreatography
Ming Zhuang, Wen-Jie Zhang, Jun Gu, Ying-Bin Liu, Xue-Feng Wang
Ming Zhuang, Wen-Jie Zhang, Jun Gu, Ying-Bin Liu, Xue-Feng Wang, Department of General Surgery, Xin Hua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
Author contributions: Zhuang M wrote the manuscript; Wang XF and Zhuang M finished the ERCP procedure together; Zhang WJ, Gu J and Liu YB were involved in editing the manuscript.
Correspondence to: Xue-Feng Wang, MD, Department of General Surgery, Xin Hua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Kongjiang Road 1665, Yangpu District, Shanghai 200092, China. wxxfd@live.cn
Telephone: +86-21-25077905 Fax: +86-21-65795173
Received: August 17, 2012
Revised: September 10, 2012
Accepted: September 28, 2012
Published online: December 21, 2012
Abstract

This case reports an application of conventional duodenoscope in a post pancreaticoduodenectomy patient with the help of retrieval balloon assisted enterography. The 56-year-old woman had pancreaticoduodenectomy with Child reconstruction 9 mo ago because of pancreatic adenocarcinoma and now there are recurrent enlarged lymph nodes in the anastomotic stoma of hepaticojejunostomy. Considering the patient’s late-stage cancer, a plastic stent was then successfully placed there to drainage. The main challenge in this case was the extremely long afferent loop and blind cannulation through the anastomotic stoma of hepaticojejunostomy. Retrieval balloon assisted enterography is very helpful for duodenoscope going through the reconstructed intestinal tract and for the cannulation. After two weeks, the patient remained free of painful symptoms and free of fever. Liver function improved well. Four months after the placement of stent, the patient died of cachexia without jaundice, fever and abdominal pain according to her daughter’s statement.

Keywords: Endoscopic retrograde cholangiopancreatography, Pancreaticoduodenectomy, Duodenoscope, Retrieval-balloon-assisted enterography