摘要
The endoscopic approach for biliary diseases in patients with surgically altered gastrointestinal anatomy(SAGA) had been generally deemed impractical. However, it was radically made feasible by the introduction of double balloon endoscopy(DBE) that was originally developed for diagnosis and treatments for small-bowel diseases. Followed by the subsequent development of singleballoon endoscopy(SBE) and spiral endoscopy(SE), interventions using several endoscopes for biliary disease in patients with SAGA widely gained an acceptance as a new modality. Many studies have been made on this new technique. Yet, some problems are to be solved. For instance, the mutual unavailability among devices due to different working lengths and channels, and unestablished standardization of procedural techniques can be raised. Additionally, in an attempt to standardize endoscopic procedures, it is important to evaluate biliary cannulating methods by case with existence of papilla or not. A full comprehension of the features of respective scope types is also required. However there are not many papers written as a review. In our manuscript, we would like to evaluate and make a review of the present status of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography applying DBE, SBE and SE for biliary diseases in patients with SAGA for establishment of these modalities as a new technology and further improvement of the scopes and devices.
The endoscopic approach for biliary diseases in patientswith surgically altered gastrointestinal anatomy （SAGA）had been generally deemed impractical. However, it wasradically made feasible by the introduction of doubleballoon endoscopy （DBE） that was originally developedfor diagnosis and treatments for small-bowel diseases.Followed by the subsequent development of singleballoonendoscopy （SBE） and spiral endoscopy （SE）,interventions using several endoscopes for biliary diseasein patients with SAGA widely gained an acceptance asa new modality. Many studies have been made on thisnew technique. Yet, some problems are to be solved.For instance, the mutual unavailability among devicesdue to different working lengths and channels, andunestablished standardization of procedural techniquescan be raised. Additionally, in an attempt to standardizeendoscopic procedures, it is important to evaluate biliarycannulating methods by case with existence of papilla ornot. A full comprehension of the features of respectivescope types is also required. However there are notmany papers written as a review. In our manuscript,we would like to evaluate and make a review of thepresent status of diagnostic and therapeutic endoscopicretrograde cholangiopancreatography applying DBE,SBE and SE for biliary diseases in patients with SAGA forestablishment of these modalities as a new technologyand further improvement of the scopes and devices.
