Endoscopy 2007; 39(12): 1068-1071
DOI: 10.1055/s-2007-966841
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Double-balloon enteroscopy for endoscopic retrograde cholangiography in patients with a Roux-en-Y anastomosis

L.  Aabakken1 , M.  Bretthauer1 , P.  D.  Line2
  • 1Department of Medicine, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway
  • 2Department of Transplantation Surgery, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway
Further Information

Publication History

submitted 16 April 2007

accepted after revision 4 July 2007

Publication Date:
10 December 2007 (online)

Background and study aims: Double-balloon enteroscopy (DBE) has been proved to be effective for deep intubation of the small bowel. Patients with a Roux-en-Y enteroanastomosis and biliary problems have been a challenge in gastrointestinal practice because of the lack of endoscopic access to the biliary anastomosis. We report on the first case series of patients with Roux-en-Y anatomy who have been examined using DBE.

Patients and methods: Between September 2005 and May 2006, 18 endoscopic retrograde cholangiography procedures were performed in 13 patients (median age 53, range 2 - 81 years) using the DBE technique at our hospital. Most of the cases (10/13) had had a liver transplant for primary sclerosing cholangitis. The Fujinon T-series DBE system was used in all cases.

Results: The entero-enteric anastomosis was reached easily in all 18 procedures, and the end of the Roux limb was reached in 17/18 procedures. The mean intubation time was 40 minutes (range 5 - 120 minutes). Adequate imaging was achieved in all but two cases, one of whom had a native papilla. Biliary stenting was performed in two patients, stent removal in three patients, and removal of a small stone in one patient.

Conclusions: Endoscopic access and biliary cannulation in the setting of Roux-en-Y anatomy is safe and feasible using the new DBE system for enteral intubation. Adaptation of accessories would further improve the utility of the procedure.

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L. Aabakken, MD

Department of Medicine

Rikshospitalet University Hospital

Oslo 0027

Norway

Fax: +47-2307-2008

Email: larsaa@medisin.uio.no