ERCP with the Double Balloon Enteroscope in Patients with Roux-en-Y Anastomosis

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doi:10.1016/j.tgie.2007.12.008 Copyright © 2008 Elsevier Inc. All rights reserved.

ERCP with the Double Balloon Enteroscope in Patients with Roux-en-Y Anastomosis

Klaus Mönkemüller, , , Rudolf -Gallont†, Helmut Neumann, Bellutti and Malfertheiner

†Division of Surgery, Herrerra-Llerandi University Hospital, Universidad Francisco Marroquin, Guatemala City, Guatemala.

Division of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University, Universitätsklinikum Magdeburg, Magdeburg, Germany

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Endoscopic retrograde cholangiopancreatography (ERCP) is technically more challenging in patients with postsurgical anatomy, such as Roux-en-Y anastomosis, frequently mandating an operative intervention. Although limited, there is growing evidence that ERCP can be performed using the double balloon enteroscope (DBE) in patients with complex postoperative anatomy. We present the technical aspects of performing ERCP with the DBE in patients presenting with complex postsurgical anatomy having biliary problems. ERCP using the DBE is feasible in patients with complex postsurgical anatomy, permitting diagnostic and therapeutic interventions in 80% of patients.

Keywords: double balloon enteroscopy; double balloon enteroscope; cholangiography; Roux-en-Y anastomosis; hepaticojejunostomy