Usefulness of forward-viewing endoscope for endoscopic retrograde cholangiopancreatography in patients with Billroth II Gastrectomy

Jong Won Byun, Jae Woo Kim, Se Yong Sung, Ho Yeon Jung, Hyo Keun Jeon, Hong Jun Park, Moon Young Kim, Hyun Soo Kim, Soon Koo Baik

Research output: Contribution to journalArticle

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Background/Aims: Patients undergoing Billroth II (B II) gastrectomy are at higher risk of perforation during endoscopic retrograde cholangiopancreatography (ERCP). We assessed the success rate and safety of forward-viewing endoscopic biliary intervention in patients with B II gastrectomy. Methods: A total of 2,280 ERCP procedures were performed in our institution between October 2008 and June 2011. Of these, forwardviewing endoscopic biliary intervention was performed in 46 patients (38 men and 8 women with B II gastrectomy). Wire-guided selective cannulations of the common bile duct using a standard catheter and guide wire were performed in all patients. Results: The success rate of afferent loop entrance was 42 out of 46 patients (91.3%) and of biliary cannulation after the approach of the papilla was 42 out of 42 patients (100%). No serious complications were encountered, except for one case of small perforation due to endoscopic sphincterotomy site injury. Conclusions: When a biliary endoscopist has less experience and patient volume is low, ERCP with a forward-viewing endoscope is preferred because of its ease and safety in all patients with prior B II gastrectomies. Also, forward-viewing endoscope can be used to improve the success rate of biliary intervention in B II patients.

Original languageEnglish
Pages (from-to)397-403
Number of pages7
JournalClinical Endoscopy
Issue number4
Publication statusPublished - 2012 Dec 1


All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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