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Pancreatic endosonography after Billroth II gastrectomy
1Section of Digestive Diseases, Dept. of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
Endoscopy
|November 3, 2004
Summary
Endoscopic ultrasonography (EUS) of the pancreas is feasible after Billroth II gastrectomy. Linear-array echo endoscopes improve visualization, though the pancreatic neck remains challenging to image.
Area of Science:
- Gastroenterology
- Endoscopic Procedures
- Surgical Oncology
Background:
- Prior Billroth II gastrectomy is a relative contraindication for pancreatic head endoscopic ultrasonography (EUS).
- This study evaluates the feasibility and outcomes of pancreatic EUS in patients with a history of Billroth II gastrectomy.
Purpose of the Study:
- To assess the technical feasibility of pancreatic EUS in patients post-Billroth II gastrectomy.
- To compare the efficacy of radial versus linear-array echo endoscopes in visualizing pancreatic structures.
Main Methods:
- Retrospective review of 11 patients who underwent attempted pancreatic EUS after Billroth II gastrectomy.
- Analysis of visualization rates for different pancreatic regions using radial and linear-array echo endoscopes.
Main Results:
- Pancreatic EUS was technically feasible in 10 out of 11 patients.
- Linear-array echo endoscopes provided superior visualization of the superior pancreatic head and porta hepatis compared to radial echo endoscopes.
- Complete imaging of the pancreatic neck was achieved in 60% of cases with linear-array scopes, versus 25% with radial scopes.
Conclusions:
- Pancreatic EUS is a viable procedure for most patients with prior Billroth II gastrectomy.
- Linear-array echo endoscopes enhance the completeness of the pancreatic EUS examination.
- The pancreatic neck presents a visualization challenge even with advanced endoscopic techniques.