Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Mar 16, 2017; 9(3): 127-132
Published online Mar 16, 2017. doi: 10.4253/wjge.v9.i3.127
Utility of endoscopic retrograde cholangiopancreatography on biliopancreatic diseases in patients with Billroth II-reconstructed stomach
Yuji Sakai, Toshio Tsuyuguchi, Rintaro Mikata, Harutoshi Sugiyama, Shin Yasui, Masaru Miyazaki, Osamu Yokosuka
Yuji Sakai, Toshio Tsuyuguchi, Rintaro Mikata, Harutoshi Sugiyama, Shin Yasui, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chuou-ku, Chiba City 260-8670, Japan
Masaru Miyazaki, Department of General Surgery, Graduate School of Medicine, Chiba University, Chuou-ku, Chiba City 260-8670, Japan
Author contributions: Sakai Y, Tsuyuguchi T, Miyazaki M and Yokosuka O were responsible for study design, data analysis and manuscript preparation; Sakai Y wrote the paper; Sakai Y and Tsuyuguchi T performed endoscopic treatment; Mikata R, Sugiyama H and Yasui S were responsible for data collection.
Institutional review board statement: This study was conducted with approval from the local ethical committee.
Informed consent statement: All the treatment procedures were performed after obtaining informed consent in writing from the patients.
Conflict-of-interest statement: The authors have no other disclosures.
Data sharing statement: The authors will share the dataset upon written request.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yuji Sakai, MD, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuou-ku, Chiba City 260-8670, Japan. sakai4754@yahoo.co.jp
Telephone: +81-43-2262083 Fax: +81-43-2262088
Received: June 15, 2016
Peer-review started: June 17, 2016
First decision: July 27, 2016
Revised: August 18, 2016
Accepted: January 2, 2017
Article in press: January 3, 2017
Published online: March 16, 2017
Abstract
AIM

To examine the utility of endoscopic retrograde cholangiopancreatography (ERCP) on biliopancreatic diseases in the patients with Billroth II-reconstructed stomach.

METHODS

For 26 cases of biliopancreatic diseases in patients with Billroth II-reconstructed stomach, ERCP was conducted using a straight-view scope or a retrograde oblique-viewing endoscope. All the cases were patients aiming at selective insertion into the bile duct. One patient aimed at diagnosis, and 25 patients aimed at treatment. The cases in which the endoscope reached the duodenal papilla and anastomosis, and insertion into the bile duct became possible, were considered successful.

RESULTS

The rate of reaching the duodenal papilla and anastomosis was 84.7% (22/26 patients). Among the cases without reaching the duodenal papilla and anastomosis, there were 2 in which the endoscope did not pass due to tumor-induced duodenal infiltration. In 1 case, the fiber did not reach the duodenal papilla due to long afferent loop. The success rate of insertion into the bile duct in patients in which the endoscope reached the duodenal papilla and anastomosis was 90.9% (20/22 patients), and the success rate of procedures including treatment was 86.3% (19/22 patients). After treatment, mild cholangitis was observed in 1 patient (4.5%, 1/22 patients) but relieved conservatively. No other accidental symptom was observed.

CONCLUSION

It was considered that the ERCP for biliopancreatic diseases in patients with Billroth II-reconstructed stomach will become a less invasive, safe and useful examination and treatment approach.

Keywords: Billroth II-reconstructed stomach, Endoscopic retrograde cholangiopancreatography, Endoscopic papillary balloon dilatation

Core tip: It was considered that the endoscopic retrograde cholangiopancreatography for biliopancreatic diseases in patients with Billroth II-reconstructed stomach will become a less invasive, safe and useful examination and treatment approach.