| Theme |
Update of Endoscopy for Small Intestine |
| Title |
Endoscopic Treatments Using Double Balloon Endoscopy for Conditions Other than Small Intestine Diseases |
| Author |
Masaki Endo |
First Department of Internal Medicine, Iwate Medical University School of Medicine |
| Author |
Masaaki Inomata |
First Department of Internal Medicine, Iwate Medical University School of Medicine |
| Author |
Hirotsugu Inaba |
First Department of Internal Medicine, Iwate Medical University School of Medicine |
| Author |
Toshimi Chiba |
First Department of Internal Medicine, Iwate Medical University School of Medicine |
| Author |
Seishi Orii |
First Department of Internal Medicine, Iwate Medical University School of Medicine |
| Author |
Kazuyuki Suzuki |
First Department of Internal Medicine, Iwate Medical University School of Medicine |
| [ Summary ] |
Endoscopic approaches for postoperative intestinal treatment have been considered difficult due to distances from anastomotic sites, flexures in the intestine, and postoperative adhesions. However, there are a number of situations associated with Billroth-II and Roux-en-Y reconstructions in which endoscopic treatment is required for conditions such as common bile duct stones or malignant biliary obstructions. At our institution, it was possible to reach the cecum in over half of the cases requiring Roux-en-Y reconstruction using a conventional small diameter colonoscope. However, the establishment of a more reliable technique was desirable. Double balloon endoscopy (DBE) is a breakthrough that can be used to search the entire gastrointestinal tract, and provides excellent ability to be inserted into the postoperative intestinal tract. After reaching the papilla or the cecum, stable treatment is possible by gripping the interior surface. Due to the effective length and forcep diameter, there is a limit on the tools that can be used for treatment. Difficulties need to be resolved for selective biliary cannulation in a tangential direction. However, the usage of DBE provides a potentially great advance in transduodenal and transpapillary endoscopic treatments for postoperative intestines. |