Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) has been considered difficult in patients with Billroth II gastrectmised stomach. We have tried ERCP on 83 patients with Billroth II gastrectmised stomach during the last 10 years. Results improved with experience ; ERP and ERC were successfully performed in 72.3% and 70.2%, respectively, of 47 patients with Billroth II gastrectomy between May, 1984 and September, 1987. Therapeutic procedures, such as endoscopic papillotomy (EPT), endoscopic nasobiliary drainage (ENBD) and endoscopic retrograde biliary drainage (ERBD) were successfully done in 8 of the patients. In 2 patients with a common bile duct stone, we were able to extract the stone with a basket catheter after EPT. The EPT in these cases was performed as follows ; at first, ENBD with a pigtail catheter was done with a sideviewing duodenoscope JF-1 T 10, then the duodenoscope was reintroduced into the duodenal second portion through an afferent loop, and an incision of the papilla Vater was made with a diathermic needle knife in the proximal direction with the assistance of the ENBD catheter. We think the tecinique of EPT described above is safe and easy to perform and, when indicated, it is a useful method for patients with Billroth II gastrectmised stomach.
