ERCP for patients who have undergone Billroth Ⅱ gastroenterostomy and Braun anastomosis

Endoscopic retrograde cholangiopancreatography(ERCP)is efficacious in patients who have undergone Billroth Ⅱ gastroenterostomies,but the success rate decreases in patients who also have experienced Braun anastomoses.There are currently no reports describing the preferred enterography route for cannu...

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Published inWorld journal of gastroenterology : WJG Vol. 20; no. 2; pp. 607 - 610
Main Author Wu, Wen-Guang
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Co., Limited 14.01.2014
Subjects
Aged
Aged, 80 and over
Case Report
Cholangiopancreatography, Endoscopic Retrograde - instrumentation
Cholangiopancreatography, Endoscopic Retrograde - methods
Duodenoscopes
Endoscopic
enterography
Female
Gastroenterostomy - methods
Humans
Male
Middle Aged
Optimal
retrograde
route
Endoscopic retrograde cholangiopancreatography
Braun anastomosis
Gastroenterostomy
Billroth II
Optimal enterography route
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Summary:Endoscopic retrograde cholangiopancreatography(ERCP)is efficacious in patients who have undergone Billroth Ⅱ gastroenterostomies,but the success rate decreases in patients who also have experienced Braun anastomoses.There are currently no reports describing the preferred enterography route for cannulation in these patients.We first review the patient’s previous surgery records,which most often indicate that the efferent loop is at the greater curvature of the stomach.We recommend extending the duodenoscope along the greater curvature of the stomach and then advancing it through the"lower entrance"at the site of the gastrojejunal anastomosis,along the efferent loop,and through the"middle entrance"at the site of the Braun anastomosis to reach the papilla of Vater.Ten patients who had each undergone BillrothⅡgastroenterostomy and Braun anastomosis between January 2009 and December 2011 were included in our study.The overall success rate of enterography was 90% for the patients who had undergone BillrothⅡgastroenterostomy and Braun anastomosis,and the therapeutic success rate was 80%.We believe that this enterography route for ERCP is optimal for a patient who has had BillrothⅡgastroenterostomy and Braun anastomosis and helps to increase the success rate of the procedure.
Bibliography:Wen-Guang Wu;Jun Gu;Wen-Jie Zhang;Ming-Ning Zhao;Ming Zhuang;Yi-Jing Tao;Ying-Bin Liu;Xue-Feng Wang;Laboratory of General Surgery and Department of General Surgery,Xinhua Hospital,Affiliated to Shanghai Jiao Tong University,School of Medicine;Institute of Biliary Tract Disease,Shanghai Jiao Tong University School of Medicine;Department of Clinical Nutrition,Xinhua Hospital,Affiliated to Shanghai Jiao Tong University,School of Medicine
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Telephone: +86-21-25076880 Fax: +86-21-25076880
Correspondence to: Xue-Feng Wang, MD, Laboratory of General Surgery and Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, No. 1665 Kongjiang Road, Shanghai 200092, China. wxxfd@live.cn
Author contributions: Wu WG, Gu J and Wang XF designed research; Wu WG, Gu J and Wang XF performed research; Zhang WJ and Zhao MN contributed new reagents or analytic tools; Zhuang M, Tao YJ and Liu YB analyzed data; Wu WG, Gu J and Wang XF wrote the paper; Wu WG and Gu J contributed equally to this work.
ISSN:1007-9327
2219-2840
2219-2840
DOI:10.3748/wjg.v20.i2.607