Altered anatomy: Enteroscopy and ERCP procedure

Abstract Roux-en-Y entero-enteric anastomosis of the small bowel is a commonly used surgical technique. However, it excludes the afferent limb and the biliopancreatic system from conventional endoscopic access. Recent data have shown that device-assisted enteroscopy (DAE) allows endoscopic retrograd...

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Bibliographic Details
Published in:Baillière's best practice & research. Clinical gastroenterology 2012-06, Vol.26 (3), p.347-357
Main Author: Moreels, Tom G., MD, PhD
Format: Article
Language:English
Subjects:
Anastomosis, Roux-en-Y - adverse effects
Anastomosis, Roux-en-Y - methods
Catheterization - methods
Cholangiopancreatography, Endoscopic Retrograde - instrumentation
Cholangiopancreatography, Endoscopic Retrograde - methods
Device-assisted enteroscopy
Endoscopes, Gastrointestinal
Endoscopy, Gastrointestinal - instrumentation
Endoscopy, Gastrointestinal - methods
ERCP
Gastroenterology and Hepatology
Humans
Intestine, Small - pathology
Laparoscopy
Roux-en-Y
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Summary:Abstract Roux-en-Y entero-enteric anastomosis of the small bowel is a commonly used surgical technique. However, it excludes the afferent limb and the biliopancreatic system from conventional endoscopic access. Recent data have shown that device-assisted enteroscopy (DAE) allows endoscopic retrograde cholangiopancreatography (ERCP) in these patients with high success rates. Both Double-balloon, short Double-balloon, Single-balloon and Spiral enteroscopy can be used for DAE-ERCP with comparable success. This review highlights the currently available literature data on DAE-ERCP in patients with Roux-en-Y anastomosis, and discusses the clinical aspects and technical difficulties. Although DAE does increase ERCP efficacy in patients with Roux-en-Y anastomosis, it remains a challenging procedure which is open to further improvement.
ISSN:1521-6918
1532-1916
DOI:10.1016/j.bpg.2012.03.003