Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) and associated procedures are difficult to perform in patients with a surgically altered anatomy because of the extremely long length of afferent limbs that must be traversed to reach the major papilla. A new insertion method using a double-balloon endoscope or a single-balloon endoscope enables easier access to the afferent duodenal loop in a patient with Roux-en Y anastomosis. However, no standard procedure has been established, so it is desirable to accumulate more cases in the future in order to overcome various problems with such endoscopes and other treatment devices. It is hoped this will lead to further improvements in these endoscopes and devices.
