Abstract
Reaching the papilla or bilio-enteric anastomosis in patients with surgically altered anatomy makes meaningful therapeutic endoscopic treatment technically challenging. At our center, spirus enteroscopy assisted ERCP (SE-ERCP) has been performed with favorable results. Here we present 3 cases for review. In all cases, an enteroscope was prepared with the Spirus overtube and this was used to examine the upper GI tract. Spirus enteroscopy performed until reaching the papilla or bilio-enteric anastomosis. In all cases, cannulation is performed with the Cotton cannulatome. Additional endoscopic procedures demonstrated include sphincterotomy, balloon dilation, stent placement into the bile duct as well as pancreatic duct and stone extraction. Spirus enteroscopy assisted ERCP is technically feasible and allows for the performance of therapeutic interventions in patients with surgically altered anatomy. At our center over the last year, 15 spirus enteroscopy ERCPs have been performed with an 80% success rate and no complications. Current limitations include the proper endoscopic tools that can be used with an enteroscope.
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