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Korean J Pancreas Biliary Tract > Volume 16(2):2011 > Article
The Korean Journal of Pancreas and Biliary Tract 2011;16(2):135-138.
위전절제술 후 변형된 위장관 구조를 가진 환자에서 소장내시경을 이용한 총담관 담석 제거
이원경, 권병운, 김용현, 이현숙, 현경희, 강하얀, 신현덕, 김홍자
단국대학교 의과대학 내과학교실
Successful Common Bile Duct Stone Removal by Single-balloon Enteroscopy-assisted ERCP in Patients with Surgically Altered Gastrointestinal Anatomy
Won Kyung Lee, Byung Woon Kwon, Yong Hyun Kim, Hyun Suk Lee, Kyung Hee Hyun, Ha Yan Kang, Hyun Deok Shin, Hong Ja Kim
Department of Internal Medicine, Dankook University Medical College, Cheonan, Korea
Endoscopic retrograde cholangiopancreatography (ERCP) is often unsuccessful in patients with surgically altered gastrointestinal anatomy such as total gastrectony with Roux-en-Y anastomosis because of the long length of afferent limb that makes it difficult to reach the major papilla. In such cases, alternative approaches, using adult or pediatric colonoscopies or conventional forward-viewing upper endoscopy with transparent cap, have been challenged. Recently, methods using double- balloon or single-balloon enteroscopies have been reported. However, these methods can be used limitedly as long length ERCP accessories are not commercially available. We here report a case of successful common bile duct stone removal by single-balloon enteroscopy (SBE)-assisted ERCP with an overtube-assisted technique in patients with surgically altered Roux-en-Y anatomy. Compared with others, conventional length of accessories can be used for therapeutic ERCP in this method. SBE-assisted ERCP with an overtube-assisted technique can be useful salvage technique in patients with surgically altered gastrointestinal anatomy.
Keywords: Single-balloon enteroscopy, Common bile duct stone, Roux-en-Y anastomosis
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