Endoscopic Sphincterotomy in Patients with Billroth II Gastrectomy

Abstract

We attempted endoscopic sphincterotomy in 35 patients previously subjected to Billroth II gastrectomy, and succeeded in 23 of them. It is often difficult to pass the instrument along the afferent loop and the sphincterotomy incision is seldom placed in an optimal position. Although we had complications in only 2 patpients, it is likely that spincterotomy carries a higher risk in Billroth II gastrectomy patients. It should therefore be reserved for patients who are at high risk for surgery.

Billroth II gastrektomili hastalarda koledok taşlarının temizlenmesi için kısmi biliyer sfinkterotomi ile birlikte "large" balon dilatasyonun etkinliği

“…Bu hastalarda ifllemi zorlaflt›ran; afferent lupun entübasyonu, afferent lupta papillaya yaklaflma, de¤iflen safra yolu kanülas-yon yönüdür (6). Kanülasyon baflar›l› bir flekilde sa¤lansa bile de¤iflmifl papilla anatomisi ES komplikasyonlar›na yol aça-bilir (7)(8)(9). Ek olarak büyük, safra kanal› distaline impakte ve çok say›daki tafllar safra kanal›ndan zor ç›kart›l›rlar, bu nedenle zor tafl olarak isimlendirilirler (1,2).…”

Biopsy forceps fixation: Novel trick of the trade for duodenal guidewire unlooping

“…In our experiment, an examiner controlled the SPCE with a dedicated controller while making observations using a real-time monitoring system (RAPID Access; Covidien). 1 The subject, who was a 37-year-old healthy man, drank 2 L of a polyethylene glycol solution for bowel preparation. He was placed in the left lateral decubitus position, and we inserted the SPCE from his anus into the rectum.…”

“…We used the New MiniMermaid System (Mu Ltd., Shiga, Japan) reported previously. 1 The SPCE was created by connecting a dedicated fin made of silicon resin (19 mm long) with a micro-magnet to the PillCam SB2 video capsule (Covidien, Dublin, Ireland). The length and width of the entire SPCE are 45 mm and 11 mm, respectively (Fig.…”

“…[1][2][3][4][5] The currently described technique allowed successful cannulation and safe sphincterotomy in our Billroth II patient with the use of a conventional side-viewing duodenoscope and standard sphincterotome. To our knowledge, this approach has not been previously reported.…”

Duodenoscopic Transpapillary Techniques and Results in Biliary and Pancreatic Diseases: An Update

“…The desired cephalad orientation of the dia thermy wire is more difficult to achieve when approaching the papilla from below and caudad orientation of the sphincterotome risks injury to the pancreatic duct. In expert hands, however, sphincterotomy was successful in 23 of 35 attempts on patients with a Billroth II gastrectomy, with only 2 complications [33],…”