Related Experiment Video
Updated: Aug 9, 2025
03:44
Structured Approach to Colonoscopy Technique Optimization: A Single-Center Experience with Novice Endoscopists
Published on: July 11, 2025
91
Successful Intubation Using a Cap-Assisted Colonoscope for Endoscopic Retrograde Cholangiopancreatography in Patients
Kyong Joo Lee1, Se Woo Park1, Hyun Joo Jang1
1Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7, Keunjaebong-gil, Hwaseong-si 18450, Republic of Korea.
Journal of Clinical Medicine
|February 25, 2023
Summary
A cap-assisted colonoscope is effective for endoscopic retrograde cholangiopancreatography (ERCP) in Roux-en-Y (REY) reconstruction patients, especially those with side-to-side jejunojejunostomy (SS-JJ). This approach offers a high success rate for ERCP in REY patients.
Area of Science:
- Gastroenterology
- Endoscopy
- Surgical Reconstruction
Background:
- Endoscopic retrograde cholangiopancreatography (ERCP) presents significant challenges in patients with Roux-en-Y (REY) gastric bypass reconstruction.
- While balloon-assisted enteroscopy is the preferred method, its availability is limited by equipment and expertise.
- Alternative endoscopic tools are needed to improve ERCP feasibility in REY patients.
Purpose of the Study:
- To evaluate the feasibility and success rate of using a cap-assisted colonoscope as a primary tool for ERCP in patients with REY reconstruction.
- To compare the efficacy of cap-assisted colonoscopy in different types of jejunojejunostomy (JJ) configurations.
Main Methods:
- A retrospective study included 47 patients with REY reconstruction who underwent ERCP using a cap-assisted colonoscope between January 2017 and February 2022.
- The primary outcome was the success rate of intubation for ERCP.
- Secondary outcomes included cannulation success, adverse events, and factors influencing successful intubation, with rescue enteroscopy used for failed cases.
Main Results:
- The intubation success rate using a cap-assisted colonoscope was significantly higher in the side-to-side jejunojejunostomy (SS-JJ) group (89.5%) compared to the side-to-end jejunojejunostomy (SE-JJ) group (11.1%) (p < 0.001).
- Overall intubation success, including rescue techniques, was high (97.4% for SS-JJ, 88.9% for SE-JJ).
- Multivariable analysis identified SS-JJ as a significant predictor of successful intubation (OR = 37.06, p = 0.005).
Conclusions:
- A cap-assisted colonoscope is a feasible and effective primary approach for ERCP in REY reconstruction patients, particularly those with SS-JJ anatomy.
- The SS-JJ configuration facilitates easier identification of the afferent limb, leading to higher ERCP success rates.
- This technique can be a valuable alternative when specialized enteroscopy equipment or expertise is unavailable.
Related Concept Videos
01:26Endoscopic Procedures V: ERCP
655
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Patient...
655
01:28Endoscopic Procedures III: Video Capsule Endoscopy
287
Capsule endoscopy, or wireless or video capsule endoscopy, is a diagnostic procedure for examining the entire gastrointestinal tract. Patients swallow a capsule about the size of a vitamin tablet. The capsule is equipped with a transmitter, a battery, an LED light source, and a color video camera to capture images throughout the gastrointestinal tract. This procedure is particularly useful for diagnosing conditions such as Crohn's disease, ulcerative colitis, tumors, polyps, ulcers,...
287
01:25Endoscopic Procedures II: Colonoscopy
162
The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
162
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
143
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
143
01:29Endoscopic Procedures I: Esophagogastroduodenoscopy
313
An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
During an EGD, the endoscope can be used to:
313