Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Single-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy: a technical review

  • Yuki Tanisaka (Department of Gastroenterology, Saitama Medical University International Medical Center) ;
  • Masafumi Mizuide (Department of Gastroenterology, Saitama Medical University International Medical Center) ;
  • Akashi Fujita (Department of Gastroenterology, Saitama Medical University International Medical Center) ;
  • Rie Shiomi (Department of Gastroenterology, Saitama Medical University International Medical Center) ;
  • Takahiro Shin (Department of Gastroenterology, Saitama Medical University International Medical Center) ;
  • Kei Sugimoto (Department of Gastroenterology, Saitama Medical University International Medical Center) ;
  • Shomei Ryozawa (Department of Gastroenterology, Saitama Medical University International Medical Center)
  • Received : 2023.01.04
  • Accepted : 2023.01.28
  • Published : 2023.11.30
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Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy is technically challenging. For example, scope insertion, selective cannulation, and intended procedures, such as stone extraction or stent placement, can be difficult. Single-balloon enteroscopy (SBE)-assisted ERCP has been used to effectively and safely address these technical issues in clinical practice. However, the small working channel limits its therapeutic potential. To address this shortcoming, a short-type SBE (short SBE) with a working length of 152 cm and a channel of 3.2 mm diameter has recently been introduced. Short SBE facilitates the use of larger accessories to complete certain procedures, such as stone extraction or self-expandable metallic stent placement. Despite the development in the SBE endoscope, various steps have to be overcome to successfully perform such procedure. To improve success, the challenging factors of each procedure must be identified. At the same time, endoscopists need to be mindful of adverse events, such as perforation, which can arise due to adhesions specific to the surgically altered anatomy. This review discussed technical tips regarding SBE-assisted ERCP in patients with surgically altered anatomy to increase success and reduce the risk of adverse events associated with ERCP.

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References

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