Features of endoscopic interventions in the pancreato-biliary zone in patients operated by Billrot-II

Abstract

The aim of the study was to evaluate the effectiveness of endoscopic retrograde cholangiopancreatography after short-loop Billrot II surgeries. Results. An analysis of 11 cases of 22 cases of endoscopic retrograde cholangiopancreatography (ERCP) after short-loop Billrot II surgeries was performed. Distal malignant strictures of the bile ducts were an indication for surgery in 6 cases, gallstones in 16. The success rate of choledochal catheterization was 100%, and the success rate of surgery was 95%. In one case, it was not possible to install a plastic stent with a dense stricture of the bile duct formed by a tumor of the pancreatic head. Stone removal using traditional baskets was effective in 100% of cases. Successful installation of plastic stents was performed in 12 cases (strictures - 4, complicated bile duct stones - 8). Conclusion. Endoscopic interventions in the pancreatobiliary zone after gastric resection with the formation of a Billrot II anastomosis are technically difficult and must be performed by an experienced endoscopist. Special technical devices and tools have been introduced to facilitate such operations. Endoscopes with end optics have some advantages in positioning, cannulation, sphincterotomy, and calculus extraction, but there are some limitations in stenting capabilities compared to traditional duodenoscopes, such as maximum stent diameter and pressure force.