2017 Volume 31 Issue 5 Pages 809-820
Endoscopic approach using conventional endoscopes for pancreatobiliary disease in patients with surgically altered gastrointestinal anatomy had been considered difficult. The percutaneous or surgical treatments were the first line policy. However, application of balloon assisted endoscopes (BAE) radically made it possible. Today numbers of studies have been reported. The recent multicenter prospective study reported; the success rate of reaching the blind end was 97.7%, the success rate of cholangiography imaging was 96.4%, the success rate of ERCP-related interventions was 97.9%, and the occurrence of adverse event was 10.6%, which proved the efficacy and the safety of the procedure.
Furthermore, ERCP for pancreatobiliary disease in patients with surgically altered gastrointestinal anatomy (except for Billroth I method) using BAE was granted additional points for the health insurance coverage by the revision of medical payment system in 2016. This therapeutic modality with BAE is widely accepted as the standard treatment policy for such patients, and an increasing demand is expected.