Endoscopy 1995; 27(3): 229-232
DOI: 10.1055/s-2007-1005676
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Needle-Knife Sphincterotomy Guided by a Biliary Endoprosthesis in Billroth II Gastrectomy Patients

H. R. van Buuren1 , J. Boender2 , G. A. J. J. Nix2 , M. van Blankenstein1
  • 1Department of Gastroenterology, Rotterdam University Hospital, Rotterdam, Netherlands
  • 2Department of Radiology, Rotterdam University Hospital, Rotterdam, Netherlands
Further Information

Publication History

Publication Date:
17 March 2008 (online)

Abstract

Background and Study Aims: All available techniques for performing endoscopic sphincterotomy in Billroth II gastrectomy patients have their limitations, and no standard technique has emerged. A new technique, needle-knife sphincterotomy guided by a thin (7 Fr) biliary endoprosthesis, is described here that overcomes some of the limitations of other techniques.

Patients and Methods: The technique was attempted in 19 nonselected patients during a three-year period. The results were retrospectively assessed. The outcome variables were the achievement of an adequate sphincterotomy and complications.

Results: An adequate sphincterotomy could be performed without much technical difficulty in 18 of the 19 patients. There was one complication, a retroperitoneal leakage, that settled with conservative treatment.

Conclusions: In patients with Billroth II anastomoses, endoprosthesis-guided sphincterotomy is a new and relatively easy procedure, which is especially attractive once selective bile duct cannulation has been achieved. This technique allows the performance of sphincterotomy as a well-controlled procedure, and may, therefore, be safer than nonguided techniques. In contrast to previously reported guided techniques using nasobiliary cannulas, the endoprosthesis technique does not necessitate withdrawing and reinserting the endoscope.