Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST) are the mainstays of the diagnosis and treatment of variable hepatobiliary and pancreatic diseases. The success rate of ERCP and EST in patients who have undergone a Billroth II gastrectomy is lower than in patients with a normal anatomy. Because the view of the ampulla is rotated 180^o in patients with Billroth II, several methods (ex, precut biliary needle-knife papillotome or wire-guided billroth II papillotome) have been used for endoscopic sphincterotomy instead of a pull-type papillotome. Using the recently devised pull-type and rotatable papillotome (Autotome^Ⱂ), we performed successful ERCP and EST in 2 patients with a Billroth II gastrectomy without complications. (Korean J Gastrointest Endosc 2007;35:445-450)

• Keywords: Gastrectomy, Gastroenterostomy, Endoscopic retrograde cholaniopancreatography, Endoscopic sphincterotomy, Papillotomy