Double-balloon enteroscopy for ERCP in patients with altered GI anatomy: front-viewing, a drawback for biliary cannulation?

摘要

To the Editor:We read with interest the article by Chu et al on ERCP with a double-balloon enteroscope (DBE) in 5 patients with Billroth II gastrectomy or Roux-en-Y choledochojeju-nostomy. Despite successful advancement to the papilla in all patients, a low rate (60%) of biliary cannulation was achieved. In 3 patients, they performed papillotomy with a specially designed sphincterotome because of short accessory lengths. Although they described the low rate as attributable to the forward-viewing of the DBE, we have achieved a high success rate of biliary cannulation with the use of a DBE.