Korean J Gastrointest Endosc > Volume 35(2); 2007 > Article
Korean Journal of Gastrointestinal Endoscopy 2007;35(2): 74-79.
Billroth II 위절제술을 시행한 환자에서 누두절개술 후 풍선확장 병합술의 유용성
전대원*·최호순·박세훈·이항락·이오영·윤병철·함준수·이민호·이동후
*을지대학교 의과대학 을지병원 내과학교실, 한양대학교 의과대학 내과학교실, 응급의학교실
A Role of Endoscopic Balloon Dilatation after Partial Infundibulotomy in Billroth II Patients
Dae Won Jun, M.D.*, Ho Soon Choi, M.D., Sae Hoon Park, M.D., Hang Lak Lee, M.D., Oh Young Lee, M.D., Byung Chul Yoon, M.D., Joon Soo Hahm, M.D., Min Ho Lee, M.D. and Dong Hoo Lee, M.D.
*Department of Internal Medicine, Eulji University College of Medicine, Departments of Internal Medicine and Emergency Medicine, Hanyang University College of Medicine, Seoul, Korea
Abstract

Background/Aims:
Endoscopic retrograde cholangiopancreatography (ERCP) is difficult to perform in patients with a Billroth II anastomosis due to the anatomical alterations. This study evaluated retrospectively the efficacy and safety of endoscopic balloon dilatation after a partial infundibulotomy with a needle knife in patients who had undergone a Billroth II operation.
Methods:
Between January 1, 2004 and December 31, 2005, 11 patients, who had undergone a prior Billroth II gastrectomy, underwent ERCP because of a suspicion of pancreatobiliary diseases. Infundibulotomy was performed using a needle knife sphincterotome. After a partial infundibulotomy, a dilation balloon was passed over a prepositioned guidewire and placed in the biliary orifice. Under endoscopic and fluoroscopic control, the balloon was then inflated with diluted contrast over a period of 1 to 2 minutes.
Results:
A total of 10 patients (7 male and 3 female) were enrolled in this study. Eight had common bile duct stones, 1 bile duct cancer, and 1 pancreatic cancer. The common bile duct was dilated by a balloon. The calculi were removed in 6 patients, and a common bile duct stent was implanted in two cases via endoscopy. No complications such as acute pancreatitis or apparent infections of the biliary tracts were encountered in these cases except for mild fever, temporary high serum levels of aminotransferase and amylase after ERCP in 3 cases. No severe bleeding or perforation occurred in patients undergoing balloon dilatation.
Conclusions:
An infundibulotomy with balloon dilatation is a valuable alternative to endoscopic sphinterotomy in the treatment of patients with bile duct diseases, who have undergone prior Billroth II gastrectomies.
Key Words: Billroth II, Endoscopic retrograde cholangiopancreatography, Infundibulotomy
주요어: Billroth II 수술, 내시경 역행 담췌관 조영술, 누두 절개
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