Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) using a short-type single-balloon enteroscope (short SBE) (SIF-H290; Olympus Medical Systems, Tokyo, Japan), with a working length of 152 cm and a working channel diameter of 3.2 mm, has been reported to be effective in patients with surgically altered anatomy (SAA) [1] [2] [3]. However, endoscopic sphincterotomy (ES) in such patients is challenging, as the appearance of the papilla is inverted and the position is frequently tangential, which makes visualizing the correct incision direction difficult. Despite the effectiveness of reported devices, they do not always achieve the correct incision direction [4] [5].
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