TIPS AND TROUBLESHOOTING FOR PANCREATOBILIARY ENDOSCOPIC TREATMENT USING BALLOON-ASSISTED ENDOSCOPES IN PATIENTS WITH SURGICALLY ALTERED ANATOMY

Abstract

Pancreatobiliary endoscopic treatment using balloon-assisted endoscopes for pancreatobiliary diseases in patients with surgically altered anatomy (excluding Billroth I procedure) has become a widespread first-line treatment method since it became covered by national health insurance in 2016. However, there are many technical difficulties, and the procedural success rate varies among institutions; moreover, the procedure has not yet been standardized. In this article, the tips for pancreatobiliary endoscopic treatment using balloon-assisted endoscopes (especially double-balloon endoscopes) and troubleshooting for technically difficult cases and adverse events are described.