2018 Volume 92 Issue 1 Pages 64-68
Although balloon enteroscopy-assisted ERCP has provided marked improvement in the success of ERCP procedures in patients with surgically altered anatomy, countermeasures against adverse events are also important. We retrospectively analyzed 493 balloon enteroscopy-assisted ERCP procedures performed in our department from April 2011 to August 2017. In our department, CO2 gas supply was used in all cases. The insertion success rate was 94.1%, the procedure success rate was 88.0%, and the mean total procedure time was 57.1 minutes. There were 25 cases (5.07%, 25/493) of adverse events. Adverse events included retroperitoneal perforation (1.2%, 6/493) , mucosal laceration (1.6%, 8/493) , pancreatitis (1.8%, 9/493) , bile duct injury (0.2%, 1/493) , and gas embolism (0.2%, 1/493) . The perforation cases were conservatively repaired by clip squeezing, and in the gas embolism case, sudden oxygen desaturation and cardiopulmonary arrest occurred during the ERCP procedure, but it was possible to rescue the patient by emergency treatment. Balloon enteroscopy-assisted ERCP is useful, but serious complications may occur. Therefore, sufficient knowledge of measures including systemic management is necessary.
