Endoscopy 2020; 52(04): 307-308
DOI: 10.1055/a-1099-1325
E-Videos

Commentary

Peter D. Siersema
Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands
› Author Affiliations

In Billroth II gastrectomy, the remaining proximal stomach is anastomosed to the proximal jejunum. When performing ERCP in Billroth II anatomy, endoscopists face several technical challenges. Although traditionally conventional side-viewing duodenoscopes or forward-viewing gastroscopes were used, single- or double-balloon enteroscopy has been shown to ease ERCP in complicated reconstruction anatomy. Recently, endoscopic ultrasound (EUS)-guided gastrojejunostomy (GJ)-assisted ERCP has been introduced, which is the topic of this E-Video.

EUS-guided GJ-assisted ERCP is performed through a 15 × 10-mm lumen-apposing metal stent (LAMS) placed for creating the GJ. The technique is of interest especially in cases in which the afferent loop is not accessible because of sharp angulation or long length of the afferent limb. Therefore, EUS-guided GJ-assisted ERCP seems to be another interesting addition to the toolbox of the hepatobiliary endoscopist.



Publication History

Article published online:
25 March 2020

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