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AGA Clinical Practice Update on Nonampullary Duodenal Lesions: Expert Review.
Gastroenterology
January 2025
Division of Gastroenterology and Hepatology, Washington University School of Medicine, St. Louis, Missouri.
Description: Nonampullary duodenal polyps are found in up to 5% of all upper endoscopies; the vast majority are identified incidentally in asymptomatic patients. Although most are benign, adenomas are estimated to account for 10%-20% of these lesions. Most international guidelines recommend that all duodenal adenomas should be considered for endoscopic resection; this may be associated with a near 15% adverse event rate (predominantly bleeding and perforation) in prospective studies, with substantial local recurrence on surveillance.
View Article and Find Full Text PDFERCP in a patient with Billroth II gastrectomy: a rare case report.
Ann Med Surg (Lond)
August 2024
Department of General Surgery, University of Aleppo, Faculty of Medicine, Aleppo, Syria.
Introduction: Gangrenous cholecystitis is a serious complication of untreated gallbladder inflammation, necessitating immediate intervention. The primary resolution involves cholecystectomy, the surgical removal of the gallbladder.The Billroth II gastrectomy, named after Theodor Billroth, addresses gastric conditions by removing a portion of the stomach and reconnecting the remaining section to the small intestine.
View Article and Find Full Text PDFPractical application of the modification in endoscopic retrograde cholangiopancreatography treated common bile duct stones in patients with Billroth II gastroenterostomy in Vietnam.
Ther Adv Gastrointest Endosc
May 2024
Institute of Gastroenterology and Hepatology, 108 Military Central Hospital, No. 1 Tran Hung Dao street, Hanoi, Vietnam.
Article Synopsis
- The study investigates the effectiveness of enhanced endoscopic techniques for performing ERCP in patients who have had a Billroth II gastroenterostomy in Vietnam.
- Out of 42 patients, the forward-viewing endoscope resulted in a significantly higher successful bile duct cannulation rate (92.6%) compared to the side-viewing endoscope (30.8%).
- Post-procedure complications were mild and manageable, with no reported mortality, indicating that the altered ERCP technique can be a primary option for treating bile duct stones in this patient group.
Technical Considerations in Laparoscopic-Assisted Endoscopic Retrograde Cholangiography.
Am Surg
September 2024
Division of Acute Care Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
The use of endoscopic retrograde cholangiography (ERCP) for diagnostic and therapeutic interventions on the pancreaticobiliary system has steadily increased, but the standard approach through the oropharynx is prohibited after Roux-en-Y (RYGB) gastric bypass surgery. Laparoscopic access to the gastric remnant allows for the completion of ERCP using the standard side-viewing duodenoscope to facilitate the completion of standard and advanced endoscopic maneuvers. Here, we describe our experience with the technical aspects of safe and effective performance of laparoscopic-assisted ERCP.
View Article and Find Full Text PDFEndoscopic Biliary Drainage in Surgically Altered Anatomy.
Diagnostics (Basel)
December 2023
Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital-IRCCS, Via Manzoni 56, Rozzano, 20089 Milan, Italy.
Endoscopic retrograde cholangiopancreatography (ERCP) is considered the preferred method for managing biliary obstructions. However, the prevalence of surgically modified anatomies often poses challenges, making the standard side-viewing duodenoscope unable to reach the papilla in most cases. The increasing instances of surgically altered anatomies (SAAs) result from higher rates of bariatric procedures and surgical interventions for pancreatic malignancies.
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