ERCP using double-balloon enteroscopy in patients with Roux-en-Y anatomy

Area of Science:

• Gastroenterology
• Endoscopy
• Surgical Anatomy

Background:

• Roux-en-Y anatomy presents significant challenges for conventional endoscopic retrograde cholangiopancreatography (ERCP).
• Previous endoscopic interventions in these patients often required percutaneous or surgical approaches due to anatomical distortions.
• Double-balloon enteroscopy (DBE) has emerged as a potential solution for navigating complex gastrointestinal anatomies.

Purpose of the Study:

• To evaluate the feasibility and success rate of DBE for performing ERCP in patients with Roux-en-Y altered anatomy.
• To assess the utility of DBE in cases where conventional endoscopy is difficult or impossible.

Main Methods:

• A retrospective case series involving 6 patients with various types of Roux-en-Y altered anatomy.
• Performance of endoscopic retrograde cholangiopancreatography (ERCP) using double-balloon enteroscopy (DBE).

Main Results:

• DBE-ERCP was successfully performed in 5 out of 6 patients (83.3% success rate).
• The study confirmed the feasibility of DBE for ERCP in this challenging patient group.
• DBE facilitated endoscopic therapy in anatomies previously requiring alternative invasive methods.

Conclusions:

• Double-balloon enteroscopy (DBE) is a feasible and effective method for performing ERCP in patients with Roux-en-Y anatomy.
• DBE can overcome the limitations of conventional scopes in managing complex biliary and pancreatic duct access in these patients.
• This approach potentially reduces the need for more invasive percutaneous or surgical interventions.