Endoscopic-Retrograde Cholangiopancreatography in Patients with Surgical Modification of Anatomy.
Summary of "Endoscopic-Retrograde Cholangiopancreatography in Patients with Surgical Modification of Anatomy."
Endoscopic retrograde cholangiopancreatography (ERCP) is an essential element in treating disease of the bilio-pancreatic system. In some patients, access to the bile ducts is limited due to operatively altered anatomy. The aim of this review is to illustrate the endoscopic procedure in these patients. We present the available evidence and comment on our approach to ERCP in patients with surgical modification of anatomy. In conclusion, conventional side-viewing or forward-viewing endoscopes allow one to access the biliary system in most patients with Billroth-II or partial pancreaticoduodenectomy. By use of balloon enteroscopy, biliary intervention in spite of surgical reconstruction with a long limb - such as Roux-en-Y gastrojejunostomy or hepaticojejunostomy and gastric bypass for obesity - has become feasible in many cases. Adaption of accessory devices to balloon-assisted enteroscopes permits therapeutic interventions in these patients.
Affiliation
Medizinische Klinik I, Klinikum der Johann-Wolfgang-Goethe-Universität.
Journal Details
This article was published in the following journal.
Name: Zeitschrift fur Gastroenterologie
ISSN: 1439-7803
Pages: 839-849
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20687021
- DOI: http://dx.doi.org/10.1055/s-0029-1245489
Medical and Biotech [MESH] Definitions
Sphincterotomy, Endoscopic
Incision of Oddi's sphincter or Vater's ampulla performed by inserting a sphincterotome through an endoscope (DUODENOSCOPE) often following retrograde cholangiography (CHOLANGIOPANCREATOGRAPHY, ENDOSCOPIC RETROGRADE). Endoscopic treatment by sphincterotomy is the preferred method of treatment for patients with retained or recurrent bile duct stones post-cholecystectomy, and for poor-surgical-risk patients that have the gallbladder still present.
Cholangiopancreatography, Endoscopic Retrograde
Fiberoptic endoscopy designed for duodenal observation and cannulation of VATER'S AMPULLA, in order to visualize the pancreatic and biliary duct system by retrograde injection of contrast media. Endoscopic (Vater) papillotomy (SPHINCTEROTOMY, ENDOSCOPIC) may be performed during this procedure.
Pancreatitis
INFLAMMATION of the PANCREAS. Pancreatitis is classified as acute unless there are computed tomographic or endoscopic retrograde cholangiopancreatographic findings of CHRONIC PANCREATITIS (International Symposium on Acute Pancreatitis, Atlanta, 1992). The two most common forms of acute pancreatitis are ALCOHOLIC PANCREATITIS and gallstone pancreatitis.
Refractive Surgical Procedures
Surgical procedures employed to correct REFRACTIVE ERRORS such as MYOPIA; HYPEROPIA; or ASTIGMATISM. These may involve altering the curvature of the CORNEA; removal or replacement of the CRYSTALLINE LENS; or modification of the SCLERA to change the axial length of the eye.
Anatomy, Cross-sectional
Descriptive anatomy based on three-dimensional imaging (IMAGING, THREE-DIMENSIONAL) of the body, organs, and structures using a series of computer multiplane sections, displayed by transverse, coronal, and sagittal analyses. It is essential to accurate interpretation by the radiologist of such techniques as ultrasonic diagnosis, MAGNETIC RESONANCE IMAGING, and computed tomography (TOMOGRAPHY, X-RAY COMPUTED). (From Lane & Sharfaei, Modern Sectional Anatomy, 1992, Preface)
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