ERCP in Billroth II gastroenterostomy and Braun anastomosis: a new technique to access the papilla

Abstract Text ERCP has 83% success rate in Billroth II, but only 29% in those with an additional Braun anastomosis. Five patients with Billroth II and Braun anastomosis were referred to our center with choledocholithiasis. In all cases the initial attempt to reach the papilla with the side-view scope alone was unsuccessful. The "clipped guidewire & balloon catheter" method involves a straight-view scope reaching the ampulla and a guidewire passing through the scope; its proximal tip is then clipped with a TTS clip close to the papilla. The scope is withdrawn with a free guidewire being left in place. The side-viewing scope is inserted over this guidewire and a balloon catheter over the wire to stiffen it. The wire/catheter’s presence greatly facilitates the intubation of the afferent loop and the optimal direction to reach the papilla, which was achieved in all 5 cases.

Video http://data.process.y-congress.com/ScientificProcess/Data//106/474/1197/b7c9bf35-7084-4c37-a898-53e20e798d84/Uploads/13821_ERCP_in%20Billroth%20II%20gastroenterostomy%20and%20Braun%20anastomosis.mp4

 

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Conflicts of interest

Authors do not have any conflict of interest to disclose.

Publikationsverlauf

Artikel online veröffentlicht:
15. April 2024