Endoscopy 2017; 49(12): 1256-1261
DOI: 10.1055/s-0043-117406
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

Comparison of two fluoroscopic images to ensure efficient scope insertion for biliary intervention in patients with Roux-en-Y hepaticojejunostomy

Koichiro Tsutsumi
Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
,
Hironari Kato
Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
,
Ken Hirao
Department of Internal Medicine, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
,
Sho Mizukawa
Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
,
Shinichiro Muro
Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
,
Yutaka Akimoto
Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
,
Daisuke Uchida
Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
,
Kazuyuki Matsumoto
Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
,
Takeshi Tomoda
Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
,
Shigeru Horiguchi
Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
,
Shuntaro Yabe
Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
,
Hiroyuki Seki
Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
,
Yasuhiro Noma
Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
,
Naoki Yamamoto
Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
,
Ryo Harada
Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
,
Tsuneyoshi Ogawa
Department of Internal Medicine, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
,
Hiroyuki Okada
Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
› Author Affiliations
Further Information

Publication History

submitted 09 March 2017

accepted after revision 30 June 2017

Publication Date:
12 September 2017 (eFirst)

Abstract

Background and study aims No standard procedure for endoscopic retrograde cholangiopancreatography is available for patients with Roux-en-Y hepaticojejunostomy (RYHJ) with side-to-end hepaticojejunostomy. We therefore explored methods of efficient scope insertion at a hepaticojejunostomy site.

Patients and methods Patients with suspected biliary disease were prospectively enrolled. Based on two fluoroscopic images obtained on scope insertion into each lumen of a two-pronged Roux-en-Y anastomosis, we selected the lumen in which the distal end of the scope progressed toward the patient’s liver or head. The accuracy of this method for selecting the correct lumen leading to the hepaticojejunostomy site was investigated.

Results Of the 33 included patients, successful insertion to the hepaticojejunostomy site was achieved in 32 (97 %), 26 (81 %) of whom had undergone the imaging method. The accuracy of the method was 88 % (23/26). The time required for insertion between the anastomotic site and the hepaticojejunostomy site was shorter when the lumen selection had been correct (13 minutes [7 – 30] (n = 23) vs. 18 minutes [8 – 28] (n = 9); P = 0.95).

Conclusion This method based on two fluoroscopic images was useful for achieving efficient scope insertion in patients with RYHJ.

Trial registered at University Hospital Medical Information Network Clinical Trials Registry (UMIN000014183).