![]() They also reported that the rate of afferent loop perforation by the inexpert endoscopist (6.25%) was higher than that of the expert endoscopist (0%, p=0.053). reported that the mean procedure time of an expert endoscopist with a side-view duodenoscope (23.8 min) was significantly shorter than that of an inexpert endoscopist (40.68 min, p<0.001) in patients with a Billroth II gastrectomy. The Billroth II gastrectomy is one of the most common surgical techniques for the treatment of peptic ulcers and gastric cancer. ![]() SBEs and DBEs have enough length and balloons to overcome long-limb reconstructions, angulations, and adhesion deformities in patients with RTG with REY and PPPD. Recently, enteroscope-guided ERCP with a single-balloon enteroscope (SBE) and a double-balloon enteroscope (DBE) have been most commonly used to overcome this struggle in patients with RTG with REY and PPPD. However, it is difficult to accomplish effective intubation with a side-view duodenoscope in patients with a radical total gastrectomy with Roux-en-Y anastomosis (RTG with REY) and a pylorus-preserving pancreaticoduodenectomy (PPPD). In patients with Billroth I anastomosis, a side-view duodenoscope is a very useful tool for effective intubation and therapeutic procedures in ERCP. The most common difficulty of ERCP may be in reaching the ampulla of Vater (AOV) or a hepaticojejunostomy site in SAAs. ![]() See “Experience of the Endoscopists Matters in Endoscopic Retrograde Cholangiopancreatography in Billroth II Gastrectomy Patients” by Erkan Caglar, Deniz Atasoy, Mukaddes Tozlu, et al., on page 82-89.Įndoscopic retrograde cholangiopancreatography (ERCP) is stimulating for endoscopists, including experts in different surgically altered anatomies (SAAs), since there are many complex variations in surgical techniques.
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