Endoscopic Access to the Papilla of Vater for Endoscopic Retrograde Cholangiopancreatography in Patients with Billroth II or Roux-en-Y Gastrojejunostomy

Abstract

Most patients with Billroth II gastrojejunostomy (92% of those in the present study) and some patients with Roux-en-Y anastomosis (33% of those in the present study) can be investigated by ERCP and endoscopically treated in cases of pancreaticobiliary disorder. Braun enteroenterostomy has no negative impact on the endoscopic access to the papilla of Vater in patients with Billroth II gastrojejunostomy. Surgical reconstruction of the gastrointestinal tract to perform gastrojejunostomy should also take endoscopic requirements into account. In view of both the potential postoperative complications and endoscopic requirements, the jejunojejunostomy should be placed nearer to the gastrojejunostomy than 60 cm, and the afferent loop should be as short as possible.