Direct colangioscopy with extraction of biliary stones using a double-balloon enteroscope in patient with surgical altered anatomy: yes, we can!

Abstract Text A 83 years-old-woman with previous partial gastrectomy with Roux-en-Y gastro-jejunostomy was hospitalized for abdominal pain and jaundice. MRCP showed common bile duct dilatation (CBD) with gallstones inside. Considering the surgically altered anatomy (SAA), we perform ERCP using a double-balloon enteroscope (BE-ERCP). After the visualization of the major papilla and selective cannulation of CBD, cholangiography showed a filling defect inside compatible as a stone of 12 mm. Biliary sphincterotomy was executed by rotating a regular sphincterotome and, after endoscopic papillary balloon dilation, a direct access of the enteroscope into the CBD was thecnically executed. The stone was extracted under direct endoscopic view using a balloon catheter without any complications. BE-ERCP is a feasible and safe therapeutic procedure in SAA [1], however it requires more procedural time and higher technical skills.

Video http://data.process.y-congress.com/ScientificProcess/Data//106/474/1197/db418da9-8a91-43e9-9696-d237e83e2a26/Uploads/13821_Direct_cholangioscopy%20OBSCURED.mp4

Publication History

Article published online:
15 April 2024

• References

• 1 Sato T, Nakai Y, Kogure H. et al. ERCP using balloon-assisted endoscope versus EUS-guided treatment for common bile duct stones in Roux-en-Y gastrectomy. Gastrointest Endosc 2023; S0016-5107 (23) 028730