Endoscopic retrograde cholangiopancreatography in patients with altered anatomy: How to deal with the challenges?

Figure 1 View Billroth II. A: Endoscopic view of Billroth II gastrojejunostomy with sharp angulation towards the afferent limb while retracting the single-balloon enteroscope. Note the mucosal tear at the short angle of the afferent limb at the end of the endoscopic retrograde cholangiopancreatography procedure; B: Radiological view of the looping position of the single-balloon enteroscope in the stomach of a patient with Billroth II partial gastrectomy. The tip of the enteroscope is located in the blind end of the duodenum. The white arrow denotes the position of the deflated overtube balloon.